| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $22.91 | $22.91 | |
Aetna
| Professional | $7.94 | $22.91 | $22.91 | |
Cigna
| Professional | $70.79 | $70.79 | $89.13 | |
Hally Health
| Professional | $40.74 | $169.82 | $223.87 | |
Medica
| Facility | $14.45 | $109.65 | $109.65 |