| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,144.00 | $3,636.00 | $9,691.00 | |
Aetna
| Professional | $5,671.00 | $13,753.37 | $13,753.37 | |
BCBS
| Facility | $4,574.22 | $5,473.44 | $6,919.99 | |
Hally Health
| Professional | $120.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $1,600.00 | $5,073.00 | $8,981.00 |