| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $316.23 | $316.23 | |
Aetna
| Professional | $251.19 | $316.23 | $426.58 | |
Hally Health
| Professional | $151.36 | $602.56 | $602.56 | |
Medica
| Facility | $245.47 | $512.86 | $794.33 | |
United
| Facility | $316.23 | $549.54 | $741.31 |