| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.38 | $150.84 | $187.11 | |
Cigna
| Professional | $173.25 | $174.98 | $220.03 | |
Hally Health
| Professional | $100.00 | $125.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |