| 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 | $150.00 | $150.00 | |
Medica
| Facility | $10,398.00 | $16,433.00 | $30,268.98 | |
United
| Facility | $9,542.00 | $12,871.00 | $16,293.00 |