| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.15 | $23.15 | $23.15 | |
Aetna
| Professional | $23.15 | $23.15 | $70.00 | |
Cigna
| Professional | $70.13 | $70.13 | $87.66 | |
Hally Health
| Professional | $18.79 | $24.40 | $170.68 | |
Medica
| Facility | $23.15 | $23.15 | $80.00 |