| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.74 | $688.00 | $3,636.00 | |
BCBS
| Facility | $273.41 | $895.55 | $1,953.32 | |
Hally Health
| Professional | $131.04 | $252.16 | $862.10 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $165.00 | $891.00 | $3,685.00 |