| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.88 | $57.85 | $1,316.48 | |
Aetna
| Professional | $0.52 | $0.52 | $0.52 | |
Cigna
| Professional | $6.87 | $6.87 | $6.87 | |
Hally Health
| Professional | $100.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |