| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,367.46 | $4,760.00 | $7,120.36 | |
Hally Health
| Professional | $457.33 | $697.50 | $1,733.97 | |
Medica
| Facility | $707.50 | $15,061.00 | $48,977.74 | |
Midlands
| Facility | $873.93 | $1,805.98 | $27,232.66 | |
United
| Facility | $12,855.00 | $16,742.00 | $21,923.00 |