| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $157.04 | $180.63 | $232.60 | |
Cigna
| Professional | $184.50 | $184.50 | $289.56 | |
Hally Health
| Professional | $168.58 | $198.33 | $297.50 | |
Hally Health
| Professional | $250.32 | $257.83 | $274.42 | |
Molina
| Professional | $32.34 | $32.34 | $316.64 | |
United
| Professional | $200.55 | $273.87 | $415.86 |