| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $69.92 | $91.58 | $112.71 |
Cigna
| Facility | 26 | $97.61 | $97.61 | $97.61 |
Lucent Health
| Facility | 26 | $617.36 | $777.44 | $799.28 |
Providence
| Facility | 26 | $97.61 | $97.61 | $97.61 |