| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.30 | $17.30 | $18.39 | |
Cigna
| Professional | $18.39 | $18.39 | $18.39 | |
Hally Health
| Professional | $150.00 | $150.00 | $275.00 | |
Medica
| Facility | $17.30 | $22.49 | $100.00 | |
Medica
| Professional | $82.19 | $82.19 | $82.19 |