| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $501.19 | $1,862.09 | $5,888.44 | |
BCBS
| Facility | $954.99 | $1,148.15 | $5,128.61 | |
Hally Health
| Professional | $309.03 | $549.54 | $1,230.27 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $158.49 | $758.58 | $2,344.23 |