| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,388.76 | $1,388.76 | $1,388.76 | |
Cigna
| Facility | $110.00 | $110.00 | $135.00 | |
Hally Health
| Facility | $100.00 | $158.72 | $345.40 | |
United
| Facility | $500.00 | $899.00 | $1,373.00 |