| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.13 | $1,204.05 | $5,091.00 | |
BCBS
| Facility | $318.01 | $680.24 | $1,362.18 | |
Cigna
| Facility | $875.00 | $875.00 | $908.00 | |
Hally Health
| Professional | $87.91 | $639.79 | $1,646.49 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $165.00 | $900.00 | $3,686.00 |