| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.68 | $123.25 | $239.51 | |
Aetna
| Professional | $96.25 | $110.81 | $136.93 | |
Cigna
| Professional | $145.22 | $145.22 | $227.17 | |
Hally Health
| Professional | $117.09 | $166.03 | $257.52 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $151.80 | $160.22 | $218.34 | |
Molina
| Professional | $32.34 | $32.34 | $251.93 | |
United
| Professional | $113.14 | $168.18 | $245.72 |