| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.47 | $23.89 | $34.77 |
Cigna
| Facility | 26 | $30.82 | $30.82 | $30.82 |
Lucent Health
| Facility | 26 | $63.45 | $188.97 | $188.97 |
Providence
| Facility | 26 | $30.82 | $30.82 | $30.82 |