| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $602.56 | $5,888.44 | $7,943.28 | |
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $467.74 | $891.25 | $2,137.96 | |
United
| Facility | $588.84 | $1,202.26 | $2,344.23 |