| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $245.24 | $321.92 | |
BCBS
| Facility | $111.30 | $187.60 | $842.80 | |
Hally Health
| Professional | $113.62 | $220.00 | $348.00 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |