| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.27 | $19.27 | $19.27 | |
Cigna
| Professional | $68.79 | $98.51 | $176.25 | |
Hally Health
| Professional | $16.01 | $18.23 | $24.53 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |