| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $288.40 | $416.87 | $1,096.48 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $346.74 | $354.81 | $389.05 | |
United
| Facility | $4,786.30 | $6,606.93 | $9,549.93 |