| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $744.00 | $2,912.34 | $7,119.04 | |
Hally Health
| Professional | $95.66 | $167.00 | $576.89 | |
Medica
| Facility | $139.43 | $235.47 | $2,286.40 | |
Midlands
| Facility | $194.33 | $297.68 | $917.51 | |
United
| Facility | $1,775.00 | $3,482.00 | $5,454.00 |