| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $87.45 | $146.08 | $192.09 |
Cigna
| Facility | 26 | $106.37 | $106.37 | $106.37 |
Hally Health
| Professional | 26 | $98.51 | $140.08 | $497.39 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |