| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $36.31 | $64.57 | |
Aetna
| Professional | $23.99 | $38.02 | $48.98 | |
Cigna
| Professional | $50.12 | $50.12 | $50.12 | |
Hally Health
| Professional | $83.18 | $151.36 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $9.33 | $33.88 | $57.54 | |
United
| Professional | $40.74 | $51.29 | $75.86 |