| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,528.00 | $6,298.62 | $10,866.62 | |
Hally Health
| Professional | $438.34 | $646.71 | $1,648.38 | |
Medica
| Facility | $621.47 | $1,142.68 | $8,625.21 | |
Midlands
| Facility | $882.13 | $1,469.35 | $6,479.99 | |
United
| Facility | $1,770.00 | $5,327.00 | $8,342.00 |