| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,496.00 | $5,549.00 | $12,885.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Hally Health
| Professional | $32.81 | $34.24 | $60.42 | |
Medica
| Facility | $61.60 | $4,868.53 | $7,305.00 | |
United
| Facility | $2,126.00 | $5,847.00 | $7,305.00 |