| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.23 | $47.62 | $71.66 | |
Aetna
| Professional | $40.74 | $47.99 | $60.96 | |
Cigna
| Professional | $43.15 | $43.15 | $68.09 | |
Hally Health
| Professional | $39.29 | $46.23 | $73.13 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $59.11 | $60.10 | $63.38 | |
Molina
| Professional | $32.34 | $32.34 | $73.13 | |
United
| Professional | $48.31 | $65.80 | $104.83 |