| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $1,202.26 | $2,089.30 | |
Aetna
| Professional | $467.74 | $575.44 | $724.44 | |
Cigna
| Professional | $812.83 | $851.14 | $1,023.29 | |
Hally Health
| Professional | $346.74 | $954.99 | $1,288.25 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $707.95 | $707.95 | $1,412.54 | |
United
| Professional | $295.12 | $416.87 | $707.95 |