| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $173.78 | $363.08 | $794.33 |
Cigna
| Facility | 26 | $208.93 | $208.93 | $208.93 |
Hally Health
| Professional | 26 | $186.21 | $354.81 | $2,630.27 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |