| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $1,230.27 | $2,137.96 | |
Aetna
| Professional | $467.74 | $575.44 | $724.44 | |
Cigna
| Professional | $831.76 | $870.96 | $1,047.13 | |
Hally Health
| Professional | $346.74 | $954.99 | $1,318.26 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $707.95 | $707.95 | $1,412.54 | |
United
| Professional | $295.12 | $426.58 | $707.95 |