| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.19 | $80.36 | $80.36 | |
Aetna
| Professional | $66.34 | $80.36 | $94.00 | |
Cigna
| Professional | $32.49 | $46.50 | $58.13 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |