| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.37 | $122.03 | $458.65 | |
Aetna
| Professional | $69.73 | $69.73 | $91.43 | |
BCBS
| Facility | $86.40 | $244.07 | $1,241.85 | |
Cigna
| Facility | $69.73 | $69.73 | $95.63 | |
Cigna
| Professional | $69.73 | $69.73 | $95.63 | |
Hally Health
| Professional | $69.73 | $168.96 | $354.30 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $90.65 | $90.65 | $90.65 | |
United
| Professional | $69.73 | $69.73 | $129.57 |