| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.68 | $23.68 | $23.68 | |
Aetna
| Professional | $8.00 | $23.68 | $23.68 | |
Cigna
| Professional | $70.50 | $71.20 | $88.13 | |
Hally Health
| Professional | $40.86 | $155.69 | $221.40 | |
Medica
| Facility | $8.00 | $109.00 | $109.00 |