| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $700.70 | $700.70 | $700.70 | |
Aetna
| Professional | $318.75 | $318.75 | $475.00 | |
Hally Health
| Professional | $150.00 | $393.16 | $393.16 | |
Medica
| Facility | $318.75 | $517.46 | $917.17 | |
Midlands
| Facility | $289.11 | $337.30 | $464.50 |