| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,977.00 | $4,235.59 | $7,119.04 | |
Hally Health
| Professional | $178.64 | $1,081.08 | $1,391.56 | |
Medica
| Facility | $358.77 | $1,350.88 | $3,115.89 | |
Midlands
| Facility | $416.30 | $1,620.25 | $2,424.52 | |
United
| Facility | $1,770.00 | $4,663.00 | $7,305.00 |