| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52,220.70 | $63,193.90 | $77,828.60 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $49,868.51 | $64,470.54 | $101,024.48 | |
United
| Facility | $61,129.67 | $81,468.20 | $107,516.08 |