| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $851.14 | $851.14 | $851.14 | |
BCBS
| Facility | $1,778.28 | $2,041.74 | $3,090.30 | |
Hally Health
| Professional | $645.65 | $1,778.28 | $2,454.71 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |