| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $404.13 | $404.13 | $589.29 | |
Cigna
| Professional | $104.51 | $104.51 | $104.51 | |
Hally Health
| Professional | $747.15 | $1,003.00 | $1,187.00 | |
Molina
| Professional | $30.00 | $1,500.00 | $2,500.00 |