| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $336.05 | $336.05 | $336.05 | |
Cigna
| Facility | $405.00 | $405.00 | $413.10 | |
Cigna
| Professional | $344.25 | $405.00 | $750.00 | |
Hally Health
| Professional | $3,133.22 | $3,733.02 | $4,295.47 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |