| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $13.99 | $13.99 | $13.99 | |
Hally Health
| Professional | $33.25 | $41.95 | $52.50 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 | |
United
| Professional | $23.39 | $36.18 | $58.86 |