| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $61.66 | $114.82 | $204.17 |
Cigna
| Facility | 26 | $81.28 | $81.28 | $81.28 |
Hally Health
| Professional | 26 | $77.62 | $128.82 | $467.74 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |