| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,398.00 | $2,445.96 | $16,266.13 | |
Aetna
| Professional | $2,398.00 | $2,398.00 | $4,856.00 | |
Hally Health
| Professional | $100.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |