| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.73 | $117.73 | $117.73 | |
Aetna
| Professional | $85.43 | $103.06 | $120.62 | |
Cigna
| Facility | $138.66 | $138.66 | $138.66 | |
Cigna
| Professional | $104.45 | $104.45 | $107.19 | |
Hally Health
| Professional | $105.96 | $129.50 | $224.28 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $138.03 | $153.05 | $163.09 | |
Molina
| Professional | $32.34 | $32.34 | $184.41 | |
United
| Professional | $113.85 | $157.29 | $241.49 |