| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $501.19 | $2,570.40 | $6,760.83 | |
Hally Health
| Professional | $316.23 | $446.68 | $1,148.15 | |
Medica
| Facility | $407.38 | $724.44 | $2,137.96 | |
Medica
| Facility | AS | $151.36 | $151.36 | $151.36 |
Midlands
| Professional | $616.60 | $741.31 | $891.25 | |
United
| Facility | $1,148.15 | $1,621.81 | $3,548.13 |