| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $19.05 | $19.05 | |
Aetna
| Professional | $14.13 | $23.99 | $33.11 | |
BCBS
| Professional | $47.86 | $47.86 | $57.54 | |
Cigna
| Professional | $30.90 | $45.71 | $57.54 | |
Hally Health
| Professional | $41.69 | $57.54 | $117.49 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $2.69 | $18.20 | $67.61 | |
United
| Professional | $2.82 | $18.62 | $33.88 |