| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.20 | $19.95 | $26.30 |
Cigna
| Facility | 26 | $6.76 | $31.62 | $45.71 |
Lucent Health
| Facility | 26 | $177.83 | $177.83 | $177.83 |
Moda Health
| Facility | 26 | $18.20 | $19.95 | $22.91 |
Providence
| Facility | 26 | $6.76 | $31.62 | $45.71 |