| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,277.00 | $5,549.00 | $11,100.08 | |
Hally Health
| Professional | $461.61 | $896.30 | $1,788.92 | |
Medica
| Facility | $763.10 | $1,145.83 | $5,847.00 | |
Medica
| Facility | AS | $227.53 | $227.53 | $227.53 |
Midlands
| Facility | $717.22 | $1,093.88 | $1,380.43 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |