| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.00 | $198.24 | $8,078.85 | |
Aetna
| Professional | $116.00 | $116.00 | $123.25 | |
Cigna
| Professional | $80.54 | $80.54 | $80.54 | |
Hally Health
| Professional | $120.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |