| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.20 | $18.20 | $18.20 | |
Aetna
| Professional | $16.98 | $19.95 | $26.92 | |
BCBS
| Facility | $112.20 | $125.89 | $151.36 | |
Hally Health
| Professional | $61.66 | $72.44 | $77.62 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |