| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,555.72 | $3,555.72 | $6,131.89 | |
Aetna
| Professional | $4,569.60 | $4,569.60 | $4,569.60 | |
Cigna
| Professional | $1,179.75 | $1,179.75 | $1,474.69 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 |