| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.62 | $19.05 | $38.90 |
Cigna
| Facility | 26 | $6.46 | $30.20 | $43.65 |
Lucent Health
| Facility | 26 | $169.82 | $169.82 | $169.82 |
Moda Health
| Facility | 26 | $16.98 | $18.62 | $38.90 |
Providence
| Facility | 26 | $43.65 | $43.65 | $43.65 |