| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $183.35 | $267.64 | $354.72 |
Cigna
| Facility | 26 | $260.99 | $260.99 | $260.99 |
Hally Health
| Professional | 26 | $174.60 | $265.27 | $973.16 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |