| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $178.20 | $178.20 | $199.94 |
Cigna
| Facility | 26 | $224.38 | $262.20 | $348.49 |
Medica
| Facility | 26 | $799.28 | $799.28 | $799.28 |
Quartz
| Facility | 26 | $203.25 | $799.28 | $799.28 |