| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.87 | $73.58 | $95.42 | |
Cigna
| Facility | $20.82 | $59.76 | $103.46 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |