| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,964.00 | $7,119.04 | $13,783.32 | |
Aetna
| Professional | $912.27 | $912.27 | $912.27 | |
Hally Health
| Professional | $150.00 | $22,491.84 | $22,491.84 | |
Medica
| Facility | $1,404.90 | $16,293.00 | $47,928.08 | |
United
| Facility | $10,352.00 | $13,970.00 | $23,884.54 |