| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,277.00 | $5,549.00 | $11,100.08 | |
Hally Health
| Professional | $142.69 | $225.12 | $697.71 | |
Medica
| Facility | $192.31 | $356.16 | $5,847.00 | |
Medica
| Facility | AS | $69.33 | $69.33 | $69.33 |
Midlands
| Facility | $234.04 | $333.34 | $454.54 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |