| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.72 | $61.94 | $61.94 |
Cigna
| Facility | 26 | $43.62 | $43.62 | $43.62 |
Hally Health
| Professional | 26 | $38.94 | $56.02 | $175.16 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |