| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,218.00 | $3,576.15 | $7,119.04 | |
Hally Health
| Professional | $87.56 | $340.02 | $758.72 | |
Medica
| Facility | $137.41 | $415.46 | $1,712.24 | |
Midlands
| Facility | $205.77 | $560.41 | $743.66 | |
United
| Facility | $1,775.00 | $3,482.00 | $5,454.00 |