| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.65 | $109.65 | $109.65 | |
Hally Health
| Facility | $151.36 | $151.36 | $151.36 | |
Midlands
| Facility | $25,703.96 | $25,703.96 | $25,703.96 | |
Wellmark
| Facility | $194.98 | $18,197.01 | $40,738.03 |