| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $144.65 | |
BCBS
| Facility | $85.00 | $101.71 | $128.59 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |