| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.56 | $89.08 | $307.68 | |
Aetna
| Professional | $72.80 | $94.00 | $481.25 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $1.00 | $1.00 | $100.00 | |
Midlands
| Facility | $0.90 | $1.00 | $1.00 |