| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.09 | $0.09 | $0.19 | |
Aetna
| Professional | $0.09 | $0.09 | $0.09 | |
Cigna
| Professional | $128.27 | $128.27 | $128.27 | |
Hally Health
| Professional | $0.83 | $1.15 | $1.43 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $2,500.00 |