| 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 | $48.23 | $280.35 | $404.62 | |
Medica
| Facility | $96.43 | $319.52 | $560.86 | |
Midlands
| Facility | $112.82 | $370.00 | $637.42 | |
United
| Facility | $1,026.00 | $1,623.00 | $2,126.00 |