| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $35.75 | $46.55 | $70.45 |
Cigna
| Facility | 26 | $63.29 | $63.29 | $63.29 |
Lucent Health
| Facility | 26 | $130.34 | $269.66 | $269.66 |
Providence
| Facility | 26 | $63.29 | $63.29 | $63.29 |