| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.70 | $119.70 | $119.70 | |
Cigna
| Facility | $94.50 | $94.50 | $94.50 | |
Cigna
| Professional | $80.33 | $94.50 | $150.55 | |
Hally Health
| Professional | $100.00 | $100.00 | $200.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |