| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.32 | $89.32 | $89.32 | |
Aetna
| Professional | $65.40 | $78.59 | $92.56 | |
Cigna
| Facility | $105.82 | $105.82 | $105.82 | |
Cigna
| Professional | $79.45 | $79.45 | $81.77 | |
Hally Health
| Professional | $80.39 | $98.70 | $170.15 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $105.52 | $116.12 | $123.27 | |
Molina
| Professional | $32.34 | $32.34 | $139.38 | |
United
| Professional | $88.03 | $115.86 | $179.92 |