| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $25.25 | $46.56 | $77.06 |
Cigna
| Facility | 26 | $30.82 | $30.82 | $30.82 |
Hally Health
| Professional | 26 | $29.65 | $42.93 | $250.66 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |