| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $35.72 | $46.34 | $71.27 |
Cigna
| Facility | 26 | $63.56 | $63.56 | $63.56 |
Lucent Health
| Facility | 26 | $131.63 | $274.36 | $274.36 |
Providence
| Facility | 26 | $63.56 | $63.56 | $63.56 |