| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.36 | $41.36 | $41.36 | |
Aetna
| Professional | $855.25 | $855.25 | $1,124.07 | |
Cigna
| Professional | $881.33 | $881.33 | $881.33 | |
Hally Health
| Professional | $150.00 | $1,082.35 | $1,082.35 | |
Medica
| Facility | $855.25 | $1,317.09 | $2,028.99 |