| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $125.56 | $211.32 | $280.05 |
Cigna
| Facility | 26 | $164.81 | $164.81 | $164.81 |
Hally Health
| Professional | 26 | $131.65 | $183.11 | $707.62 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |