| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.76 | $45.76 | $45.76 | |
Aetna
| Professional | $45.76 | $45.76 | $216.80 | |
BCBS
| Facility | $688.48 | $823.83 | $1,041.55 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |