| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.46 | $24.46 | $24.46 | |
Aetna
| Professional | $8.00 | $24.46 | $24.46 | |
Cigna
| Professional | $76.13 | $76.89 | $95.16 | |
Hally Health
| Professional | $40.86 | $155.69 | $201.30 | |
Medica
| Facility | $8.00 | $117.55 | $117.55 |