| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57,002.20 | $68,980.20 | $84,954.80 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $54,434.65 | $70,373.67 | $110,274.63 | |
United
| Facility | $66,726.91 | $88,927.71 | $117,360.62 |