| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $50.41 | $50.41 | $150.00 | |
Medica
| Facility | $21.50 | $23.09 | $124.17 | |
Medica
| Professional | $19.00 | $31.06 | $35.00 | |
Midlands
| Facility | $35.00 | $35.00 | $35.00 | |
Midlands
| Professional | $30.00 | $31.06 | $55.88 |