| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $87.10 | $186.21 | $407.38 |
Cigna
| Facility | 26 | $107.15 | $107.15 | $107.15 |
Hally Health
| Professional | 26 | $97.72 | $162.18 | $562.34 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |