| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,906.00 | $4,235.59 | $7,119.04 | |
Hally Health
| Professional | $57.88 | $124.88 | $247.60 | |
Medica
| Facility | $121.76 | $175.41 | $1,371.00 | |
Midlands
| Facility | $134.63 | $166.04 | $234.32 | |
United
| Facility | $1,151.00 | $1,640.00 | $3,560.25 |