| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $16.50 | $21.56 | $33.85 |
Cigna
| Facility | 26 | $28.97 | $28.97 | $28.97 |
Lucent Health
| Facility | 26 | $60.16 | $124.50 | $124.50 |
Providence
| Facility | 26 | $28.97 | $28.97 | $28.97 |