| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19,949.90 | $24,142.00 | $29,732.80 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $19,051.25 | $24,629.66 | $38,594.35 | |
United
| Facility | $23,353.35 | $31,123.27 | $41,074.33 |