| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,360.02 | $1,360.02 | $1,360.02 | |
Aetna
| Professional | $1,000.00 | $1,765.00 | $1,765.00 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |