| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.66 | $2.49 | $3.83 | |
Aetna
| Professional | $1.66 | $1.66 | $1.76 | |
Cigna
| Professional | $0.52 | $0.75 | $3.56 | |
Hally Health
| Professional | $11.95 | $120.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Facility | $0.04 | $1.67 | $4.17 | |
United
| Professional | $3.67 | $4.17 | $4.42 |