| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $91.24 | $151.38 | $199.74 |
Cigna
| Facility | 26 | $110.15 | $110.15 | $110.15 |
Hally Health
| Professional | 26 | $102.43 | $145.75 | $504.60 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |