| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68,980.00 | $83,474.89 | $102,806.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $65,872.92 | $85,161.21 | $133,446.49 | |
United
| Facility | $80,748.14 | $107,613.97 | $142,021.45 |