| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $79.43 | $79.43 | |
Aetna
| Professional | $54.95 | $79.43 | $95.50 | |
Cigna
| Professional | $32.36 | $46.77 | $57.54 | |
Hally Health
| Professional | $100.00 | $199.53 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $33.88 | $42.66 | $75.86 |