| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,168.69 | $4,786.30 | $7,079.46 | |
Aetna
| Professional | $4,786.30 | $9,772.37 | $9,772.37 | |
Hally Health
| Professional | $151.36 | $9,120.11 | $9,120.11 | |
Medica
| Facility | $5,370.32 | $13,489.63 | $25,118.86 | |
United
| Facility | $4,365.16 | $7,079.46 | $25,118.86 |