| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $199.53 | $199.53 | |
BCBS
| Facility | $1,905.46 | $2,137.96 | $4,073.80 | |
Hally Health
| Facility | $100.00 | $199.53 | $346.74 | |
Molina
| Facility | $25.12 | $588.84 | $6,309.57 |