| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $17.16 | $22.41 | $35.56 |
Cigna
| Facility | 26 | $30.76 | $30.76 | $30.76 |
Lucent Health
| Facility | 26 | $62.39 | $131.05 | $131.05 |
Providence
| Facility | 26 | $30.76 | $30.76 | $30.76 |