| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.15 | $33.15 | $33.15 | |
Aetna
| Professional | $8.32 | $23.68 | $23.68 | |
Cigna
| Facility | $250.00 | $250.00 | $250.00 | |
Cigna
| Professional | $49.26 | $75.72 | $88.13 | |
Hally Health
| Professional | $42.77 | $119.85 | $247.80 |