| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $2,187.76 | $10,000.00 | $18,197.01 | |
United
| Facility | $2,754.23 | $10,964.78 | $18,620.87 | |
Wellmark
| Facility | $1,047.13 | $18,197.01 | $40,738.03 |