| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $89.13 | $89.13 | $89.13 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $89.13 | $89.13 | $89.13 |