| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $316.23 | $316.23 | $346.74 |
Cigna
| Facility | 26 | $398.11 | $467.74 | $741.31 |
Medica
| Facility | 26 | $676.08 | $676.08 | $676.08 |
Quartz
| Facility | 26 | $354.81 | $977.24 | $977.24 |