| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.17 | $23.17 | $23.17 | |
Cigna
| Facility | $150.00 | $150.00 | $150.00 | |
Cigna
| Professional | $16.39 | $61.57 | $88.13 | |
Hally Health
| Professional | $22.01 | $95.88 | $162.12 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |