| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $62.20 | $72.77 | $85.87 | |
Cigna
| Professional | $93.13 | $93.13 | $93.13 | |
Hally Health
| Professional | $150.00 | $150.00 | $275.00 | |
Medica
| Facility | $95.60 | $164.36 | $164.36 | |
Medica
| Professional | $91.30 | $91.30 | $164.87 | |
United
| Professional | $91.30 | $91.30 | $96.86 |