| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.54 | $30.54 | $30.54 | |
Aetna
| Professional | $17.87 | $30.54 | $42.00 | |
Cigna
| Professional | $150.94 | $150.94 | $150.94 | |
Hally Health
| Professional | $23.51 | $30.66 | $143.62 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |