| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $1,174.90 | $1,778.28 | $5,623.41 | |
Medica
| Facility | $1,949.84 | $3,090.30 | $11,748.98 | |
Medica
| Facility | AS | $575.44 | $575.44 | $575.44 |
Midlands
| Professional | $2,570.40 | $2,884.03 | $3,388.44 |