| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $14.73 | $19.10 | $29.17 |
Cigna
| Facility | 26 | $26.16 | $26.16 | $26.16 |
Lucent Health
| Facility | 26 | $53.69 | $147.54 | $147.54 |
Providence
| Facility | 26 | $26.16 | $26.16 | $26.16 |