| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.96 | $38.96 | $66.88 | |
Aetna
| Professional | $31.87 | $38.96 | $50.50 | |
Cigna
| Professional | $42.56 | $42.56 | $67.50 | |
Hally Health
| Professional | $38.84 | $52.69 | $86.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $56.10 | $57.08 | $62.65 | |
Molina
| Professional | $32.34 | $32.34 | $72.29 | |
United
| Professional | $37.24 | $53.89 | $81.06 |