| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.18 | $83.18 | $83.18 | |
Hally Health
| Professional | $45.71 | $61.66 | $79.43 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $1.17 | $1.17 | $1.17 | |
United
| Professional | $0.98 | $0.98 | $0.98 |