| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $52.25 | $100.78 | $130.15 |
Cigna
| Facility | 26 | $71.67 | $71.67 | $71.67 |
Hally Health
| Professional | 26 | $66.73 | $95.18 | $559.87 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |