| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $323.59 | $323.59 | $363.08 |
Cigna
| Facility | 26 | $407.38 | $478.63 | $758.58 |
Medica
| Facility | 26 | $707.95 | $707.95 | $707.95 |
Quartz
| Facility | 26 | $363.08 | $1,000.00 | $1,000.00 |