| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.15 | $37.15 | $37.15 | |
Aetna
| Professional | $19.95 | $37.15 | $37.15 | |
Cigna
| Professional | $19.50 | $19.50 | $19.50 | |
Hally Health
| Professional | $38.90 | $40.74 | $151.36 | |
Medica
| Facility | $37.15 | $39.81 | $69.18 |