| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115,528.00 | $139,804.00 | $172,180.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $110,324.32 | $142,628.44 | $223,496.89 | |
United
| Facility | $135,237.43 | $180,232.45 | $237,858.28 |