| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $151.16 | $151.16 | $151.16 | |
Medica
| Professional | $236.16 | $236.16 | $236.16 | |
Midlands
| Facility | $30.00 | $68.50 | $85.12 | |
Midlands
| Professional | $33.79 | $66.59 | $85.12 | |
Oscar Health
| Professional | $14.05 | $37.06 | $68.95 |