| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53,877.00 | $65,198.30 | $80,297.10 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $51,450.23 | $66,515.39 | $104,228.75 | |
United
| Facility | $63,068.56 | $84,052.19 | $110,926.24 |