| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $24.98 | $45.69 | $60.44 |
Cigna
| Facility | 26 | $28.97 | $28.97 | $28.97 |
Hally Health
| Professional | 26 | $28.41 | $39.06 | $128.06 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |