| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $174.30 | $294.67 | $393.03 |
Cigna
| Facility | 26 | $207.23 | $207.23 | $207.23 |
Hally Health
| Professional | 26 | $193.09 | $293.93 | $2,393.26 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |