| 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 | $1,834.61 | $2,849.85 | $6,400.00 | |
Medica
| Facility | $2,338.73 | $4,322.21 | $7,305.00 | |
Midlands
| Facility | $2,869.60 | $4,322.21 | $5,617.32 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |