| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,044.87 | $10,945.50 | $13,480.30 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $8,637.45 | $11,166.60 | $17,497.91 | |
United
| Facility | $10,587.95 | $14,110.68 | $18,622.29 |