| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.08 | $53.08 | $53.08 | |
Aetna
| Professional | $38.65 | $46.76 | $54.64 | |
Cigna
| Facility | $62.56 | $62.56 | $62.56 | |
Cigna
| Professional | $47.02 | $47.02 | $48.39 | |
Hally Health
| Professional | $47.77 | $58.65 | $111.47 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $61.95 | $69.00 | $73.70 | |
Molina
| Professional | $32.34 | $32.34 | $83.35 | |
United
| Professional | $51.33 | $68.98 | $108.02 |