| 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 | $398.62 | $619.46 | $1,566.72 | |
Medica
| Facility | $508.25 | $1,045.48 | $7,123.00 | |
Medica
| Facility | AS | $187.11 | $187.11 | $187.11 |
Midlands
| Facility | $699.41 | $1,098.58 | $1,284.77 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |