| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.31 | $26.31 | $26.31 | |
Aetna
| Professional | $9.00 | $26.31 | $26.31 | |
Cigna
| Professional | $126.00 | $127.26 | $157.50 | |
Hally Health
| Professional | $138.59 | $183.79 | $262.77 | |
Medica
| Facility | $26.31 | $44.73 | $26,642.91 |