| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.78 | $93.59 | $143.31 | |
Aetna
| Professional | $42.78 | $42.78 | $45.46 | |
Cigna
| Facility | $45.46 | $45.46 | $45.46 | |
Cigna
| Professional | $45.46 | $45.46 | $45.46 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |