| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $237.75 | $237.75 | $237.75 | |
Aetna
| Professional | $117.95 | $237.75 | $447.24 | |
Hally Health
| Professional | $23.51 | $27.66 | $40.11 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |