| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $62.72 | $113.94 | $159.19 |
Cigna
| Facility | 26 | $81.73 | $81.73 | $81.73 |
Hally Health
| Professional | 26 | $78.23 | $114.17 | $413.29 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |