| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,277.00 | $6,066.00 | $11,100.08 | |
Hally Health
| Professional | $74.90 | $92.62 | $547.00 | |
Medica
| Facility | $86.18 | $154.12 | $1,607.00 | |
Medica
| Facility | AS | $38.45 | $38.45 | $38.45 |
Midlands
| Facility | $101.55 | $133.99 | $190.76 | |
United
| Facility | $1,204.00 | $1,640.00 | $2,126.00 |