| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $680.72 | $680.72 | $736.52 | |
Aetna
| Professional | $376.69 | $376.69 | $376.69 | |
Hally Health
| Professional | $150.00 | $487.80 | $487.80 | |
Medica
| Facility | $449.50 | $699.32 | $1,010.04 |