| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $3,981.07 | $6,760.83 | |
Hally Health
| Professional | $112.20 | $173.78 | $489.78 | |
Medica
| Facility | $263.03 | $3,467.37 | $7,943.28 | |
Midlands
| Professional | $263.03 | $288.40 | $549.54 | |
United
| Facility | $1,819.70 | $4,570.88 | $8,317.64 |