| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $16.98 | $30.20 | $41.69 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $151.36 | $151.36 | $151.36 | |
Hally Health
| Professional | $23.44 | $33.88 | $144.54 | |
Molina
| Professional | $30.20 | $30.20 | $100.00 |