| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,964.00 | $6,960.00 | $11,611.47 | |
Aetna
| Professional | $7,592.00 | $7,592.00 | $7,592.00 | |
Hally Health
| Professional | $150.00 | $12,925.00 | $12,925.00 | |
Medica
| Facility | $5,434.24 | $8,412.12 | $11,051.00 | |
United
| Facility | $4,700.00 | $7,805.64 | $10,320.00 |