| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $14.73 | $19.10 | $29.59 |
Cigna
| Facility | 26 | $26.51 | $26.51 | $26.51 |
Lucent Health
| Facility | 26 | $54.32 | $147.54 | $147.54 |
Providence
| Facility | 26 | $26.51 | $26.51 | $26.51 |