| 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 | $315.12 | $505.65 | $3,020.70 | |
Medica
| Facility | $404.89 | $715.21 | $1,640.00 | |
Medica
| Facility | AS | $152.59 | $152.59 | $152.59 |
Midlands
| Facility | $575.52 | $733.61 | $954.45 | |
United
| Facility | $1,204.00 | $1,640.00 | $2,126.00 |