| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.21 | $184.14 | $258.30 | |
Aetna
| Facility | 25 | $66.36 | $185.36 | $328.00 |
BCBS
| Facility | $42.39 | $43.39 | $125.93 | |
Cigna
| Facility | $13.19 | $13.19 | $155.00 | |
Hally Health
| Professional | $13.30 | $19.60 | $151.29 |