| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $102.33 | $102.33 | |
Aetna
| Professional | $61.66 | $100.00 | $128.82 | |
Cigna
| Professional | $57.54 | $57.54 | $154.88 | |
Hally Health
| Professional | $93.33 | $125.89 | $169.82 | |
United
| Professional | $46.77 | $60.26 | $81.28 |