| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.00 | $95.00 | $95.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Wellmark
| Facility | $46.00 | $18,170.00 | $40,290.00 |
Medical Social Services-General
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.00 | $95.00 | $95.00 | |
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Wellmark
| Facility | $46.00 | $18,170.00 | $40,290.00 |