| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.00 | $24.00 | $24.00 | |
Cigna
| Professional | $0.79 | $1.12 | $1.41 | |
Hally Health
| Professional | $12.87 | $17.57 | $100.00 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $0.68 | $0.68 | $1.87 |