| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $295.12 | $436.52 | $1,122.02 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $363.08 | $363.08 | $398.11 | |
United
| Facility | $4,168.69 | $5,495.41 | $8,912.51 |