| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31,045.20 | $37,568.80 | $46,269.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $29,646.81 | $38,327.71 | $60,059.01 | |
United
| Facility | $36,341.56 | $48,432.81 | $63,918.26 |