| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $418.30 | $662.16 | $662.16 |
Cigna
| Facility | 26 | $462.59 | $462.59 | $462.59 |
Hally Health
| Professional | 26 | $413.03 | $607.37 | $2,878.69 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |