| 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 | $250.00 | $250.00 | |
Medica
| Facility | $209.73 | $490.88 | $760.75 | |
Midlands
| Facility | $195.42 | $227.99 | $313.97 |