| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108,933.00 | $131,823.00 | $162,351.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $104,025.92 | $134,485.79 | $210,737.48 | |
United
| Facility | $127,516.75 | $169,943.00 | $224,278.99 |