| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,930.26 | $7,176.40 | $8,838.33 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $5,663.14 | $7,321.37 | $11,472.49 | |
United
| Facility | $6,941.98 | $9,251.65 | $12,209.68 |