| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $776.25 | $1,778.28 | |
Aetna
| Professional | $316.23 | $316.23 | $446.68 | |
Cigna
| Professional | $52.48 | $52.48 | $52.48 | |
Hally Health
| Professional | $151.36 | $741.31 | $741.31 | |
Medica
| Facility | $316.23 | $512.86 | $977.24 | |
United
| Facility | $501.19 | $870.96 | $1,148.15 |