| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $141.25 | |
Aetna
| Professional | $109.65 | $141.25 | $141.25 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
Hally Health
| Professional | $169.82 | $194.98 | $213.80 | |
Medica
| Facility | $131.83 | $141.25 | $218.78 |