| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $701.68 | $701.68 | $701.68 | |
Aetna
| Professional | $751.56 | $751.56 | $890.93 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Hally Health
| Professional | $150.00 | $1,082.35 | $1,082.35 | |
Medica
| Facility | $751.56 | $1,157.40 | $2,028.99 |