| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $172.24 | $275.38 | $382.68 |
Cigna
| Facility | 26 | $209.30 | $209.30 | $209.30 |
Hally Health
| Professional | 26 | $183.12 | $286.20 | $2,354.80 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |