| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.38 | $20.38 | $20.38 | |
Aetna
| Professional | $20.38 | $20.38 | $21.66 | |
Cigna
| Professional | $11.90 | $11.90 | $11.90 | |
Hally Health
| Professional | $120.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |