| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.28 | $63.28 | $69.29 | |
Aetna
| Professional | $63.28 | $69.29 | $70.81 | |
Cigna
| Professional | $85.15 | $85.15 | $99.68 | |
Hally Health
| Professional | $82.00 | $105.61 | $147.59 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |