| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.80 | $64.80 | $200.00 | |
Aetna
| Professional | $64.80 | $64.80 | $70.40 | |
Cigna
| Professional | $27.79 | $27.79 | $27.79 | |
Hally Health
| Professional | $68.13 | $88.69 | $158.35 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |