| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,202.26 | $1,202.26 | $1,202.26 | |
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $1,202.26 | $1,202.26 | $1,202.26 | |
United
| Facility | $1,288.25 | $1,288.25 | $1,905.46 |