| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $831.76 | $831.76 | $831.76 | |
Hally Health
| Professional | $562.34 | $1,047.13 | $2,290.87 | |
Medica
| Facility | $588.84 | $977.24 | $1,412.54 | |
Midlands
| Professional | $977.24 | $1,288.25 | $1,621.81 |