| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,234.00 | $3,795.64 | $7,119.04 | |
Hally Health
| Professional | $150.86 | $627.52 | $1,192.50 | |
Medica
| Facility | $227.16 | $706.20 | $1,381.34 | |
Midlands
| Facility | $288.20 | $854.84 | $1,412.51 | |
United
| Facility | $1,026.00 | $1,607.00 | $1,966.00 |