| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $171.52 | $171.52 | $182.24 | |
Cigna
| Professional | $182.24 | $182.24 | $182.24 | |
Hally Health
| Professional | $150.00 | $150.00 | $275.00 | |
Medica
| Facility | $171.52 | $205.82 | $804.00 | |
Medica
| Professional | $814.72 | $814.72 | $814.72 |