| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $49.81 | $51.12 | $51.12 | |
BCBS
| Facility | $84.61 | $101.24 | $128.00 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $55.50 | $55.50 | $55.50 |