| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.02 | $0.03 | $0.03 | |
Aetna
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $25.19 | $25.44 | $31.49 | |
Hally Health
| Professional | $16.95 | $23.83 | $120.00 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |