| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,906.00 | $4,235.59 | $7,119.04 | |
Hally Health
| Professional | $74.09 | $184.48 | $420.92 | |
Medica
| Facility | $113.49 | $211.40 | $1,607.00 | |
Midlands
| Facility | $168.90 | $302.04 | $439.03 | |
United
| Facility | $1,204.00 | $1,623.00 | $2,126.00 |