| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $106.66 | $178.66 | $240.30 |
Cigna
| Facility | 26 | $131.08 | $131.08 | $131.08 |
Hally Health
| Professional | 26 | $112.96 | $156.77 | $629.39 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |