| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $88.00 | $88.00 | $88.00 | |
Hally Health
| Professional | $150.00 | $151.09 | $151.09 | |
Medica
| Facility | $135.52 | $185.07 | $287.88 | |
Midlands
| Facility | $160.88 | $188.76 | $259.94 |