| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $791.41 | $791.41 | $791.41 | |
Cigna
| Professional | $271.26 | $271.26 | $271.26 | |
Hally Health
| Professional | $150.00 | $1,082.35 | $1,082.35 | |
Medica
| Facility | $791.41 | $1,218.77 | $2,028.99 |