| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,964.00 | $6,960.00 | $11,611.47 | |
Hally Health
| Professional | $434.74 | $751.24 | $1,323.01 | |
Medica
| Facility | $863.00 | $1,368.03 | $26,876.61 | |
Midlands
| Facility | $863.00 | $1,409.46 | $15,190.80 | |
United
| Facility | $12,198.00 | $18,164.52 | $26,782.00 |