| 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 | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $466.12 | $910.28 | $2,126.00 | |
United
| Facility | $1,204.00 | $1,623.00 | $2,126.00 |