| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,272.00 | $5,389.00 | $29,038.34 | |
BCBS
| Facility | $4,655.28 | $12,832.69 | $35,456.57 | |
Hally Health
| Professional | $1,032.39 | $1,553.51 | $4,539.52 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $2,655.00 | $8,879.00 | $35,962.00 |