| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $21.95 | $60.45 | $60.45 |
Cigna
| Facility | 26 | $26.51 | $26.51 | $26.51 |
Hally Health
| Professional | 26 | $25.67 | $37.17 | $170.91 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |