| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $247.88 | $247.88 | $277.63 |
Cigna
| Facility | 26 | $309.99 | $362.24 | $481.45 |
Medica
| Facility | 26 | $535.50 | $535.50 | $535.50 |
Quartz
| Facility | 26 | $281.58 | $535.50 | $535.50 |