| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,468.00 | $4,917.20 | $8,042.03 | |
Hally Health
| Professional | $988.94 | $1,560.94 | $3,731.20 | |
Medica
| Facility | $1,371.96 | $2,520.14 | $7,305.00 | |
Midlands
| Facility | $1,656.79 | $2,424.32 | $3,125.39 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |