| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $3,090.30 | $6,760.83 | |
Hally Health
| Professional | $74.13 | $169.82 | $467.74 | |
Medica
| Facility | $114.82 | $257.04 | $1,621.81 | |
Midlands
| Professional | $165.96 | $302.00 | $380.19 | |
United
| Facility | $1,148.15 | $1,621.81 | $3,548.13 |