| 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 | $1,151.00 | $1,914.00 | $24,797.23 | |
United
| Facility | $1,341.00 | $1,775.00 | $23,884.54 |