| 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 | $22,908.68 | $22,908.68 | |
Hally Health
| Professional | $151.36 | $21,877.62 | $21,877.62 | |
Medica
| Facility | $8,709.64 | $14,791.08 | $33,884.42 | |
United
| Facility | $8,511.38 | $13,489.63 | $30,199.52 |