| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.40 | $44.80 | $125.60 | |
Cigna
| Professional | $25.05 | $25.05 | $25.05 | |
Hally Health
| Professional | $150.00 | $150.00 | $275.00 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |