| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.33 | $62.09 | $80.38 | |
Aetna
| Professional | $10.00 | $16.04 | $22.15 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 | |
Hally Health
| Professional | $100.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |