| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $338.91 | $530.54 | $530.54 |
Cigna
| Facility | 26 | $369.73 | $369.73 | $369.73 |
Hally Health
| Professional | 26 | $332.35 | $470.90 | $1,762.00 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |