| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,277.00 | $6,066.00 | $11,100.08 | |
Hally Health
| Professional | $161.62 | $274.43 | $1,110.16 | |
Medica
| Facility | $241.44 | $408.03 | $3,396.00 | |
Medica
| Facility | AS | $79.33 | $79.33 | $79.33 |
Midlands
| Facility | $307.39 | $397.93 | $514.98 | |
United
| Facility | $2,126.00 | $5,854.53 | $7,407.10 |