| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $346.74 | $602.56 | $1,047.13 | |
Aetna
| Professional | $234.42 | $288.40 | $346.74 | |
Cigna
| Professional | $407.38 | $426.58 | $512.86 | |
Hally Health
| Professional | $281.84 | $467.74 | $645.65 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $346.74 | $346.74 | $691.83 | |
United
| Professional | $147.91 | $208.93 | $346.74 |