| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.27 | $19.27 | $19.27 | |
Aetna
| Professional | $19.27 | $19.27 | $56.00 | |
Cigna
| Professional | $141.00 | $142.41 | $176.25 | |
Hally Health
| Professional | $16.73 | $17.76 | $19.78 | |
Medica
| Facility | $19.27 | $19.27 | $80.00 |