| 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 | $227.79 | $362.34 | $842.45 | |
Medica
| Facility | $293.49 | $480.08 | $1,640.00 | |
Medica
| Facility | AS | $109.91 | $109.91 | $109.91 |
Midlands
| Facility | $417.50 | $528.39 | $692.55 | |
United
| Facility | $1,204.00 | $1,640.00 | $2,126.00 |