| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.87 | $25.87 | $25.87 | |
Aetna
| Professional | $8.00 | $25.87 | $136.00 | |
Cigna
| Professional | $70.13 | $70.83 | $87.66 | |
Hally Health
| Professional | $40.86 | $137.69 | $239.85 | |
Medica
| Facility | $8.00 | $108.27 | $108.27 |