| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35,623.90 | $43,109.60 | $53,093.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $34,019.24 | $43,980.43 | $68,916.75 | |
United
| Facility | $41,701.37 | $55,575.88 | $73,345.19 |