| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.85 | $30.85 | $30.85 | |
Aetna
| Professional | $8.00 | $30.85 | $30.85 | |
Cigna
| Professional | $102.75 | $103.78 | $128.44 | |
Hally Health
| Professional | $32.72 | $182.56 | $244.48 | |
Medica
| Facility | $8.00 | $126.95 | $126.95 |