| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,496.00 | $4,964.00 | $7,119.04 | |
Hally Health
| Professional | $621.78 | $988.26 | $2,084.16 | |
Medica
| Facility | $918.41 | $1,651.00 | $11,139.12 | |
Midlands
| Facility | $1,199.00 | $1,666.82 | $8,965.20 | |
United
| Facility | $4,217.00 | $9,076.96 | $18,346.22 |