| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.46 | $234.93 | $3,797.91 | |
Aetna
| Professional | $137.47 | $137.47 | $551.21 | |
Cigna
| Professional | $165.00 | $165.00 | $165.00 | |
Hally Health
| Professional | $120.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |