| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $374.58 | $374.58 | $415.30 | |
Aetna
| Professional | $513.79 | $513.79 | $513.79 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $137.26 | $277.10 | $399.05 | |
Midlands
| Facility | $106.70 | $124.48 | $171.42 |