| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.00 | $88.00 | $88.00 | |
Aetna
| Professional | $84.27 | $88.00 | $160.75 | |
BCBS
| Facility | $131.55 | $157.41 | $199.01 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |