| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $72.00 | $72.00 | $72.00 | |
Medica
| Professional | $46.00 | $500.00 | $500.00 | |
Midlands
| Facility | $72.00 | $72.00 | $72.00 | |
Midlands
| Professional | $46.00 | $54.00 | $144.16 | |
Oscar Health
| Professional | $46.60 | $82.00 | $118.30 |