| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $788.71 | $788.71 | $1,010.59 | |
Aetna
| Professional | $531.89 | $531.89 | $908.72 | |
Cigna
| Professional | $862.50 | $862.50 | $862.50 | |
Hally Health
| Professional | $150.00 | $1,082.35 | $1,082.35 | |
Medica
| Facility | $250.60 | $737.93 | $2,028.99 |