| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.21 | $36.21 | $36.21 | |
Aetna
| Professional | $8.32 | $25.87 | $136.00 | |
Cigna
| Facility | $250.00 | $250.00 | $250.00 | |
Cigna
| Professional | $18.77 | $61.24 | $87.66 | |
Hally Health
| Professional | $42.77 | $100.00 | $255.45 |