| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.22 | $104.22 | $104.22 | |
Hally Health
| Professional | $150.00 | $199.98 | $199.98 | |
Medica
| Facility | $160.50 | $279.41 | $434.64 | |
Midlands
| Facility | $244.26 | $284.97 | $392.44 |