| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $67.12 | $87.93 | $108.26 |
Cigna
| Facility | 26 | $93.76 | $93.76 | $93.76 |
Lucent Health
| Facility | 26 | $593.12 | $746.48 | $767.44 |
Providence
| Facility | 26 | $93.76 | $93.76 | $93.76 |