| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $14.73 | $19.10 | $29.63 |
Cigna
| Facility | 26 | $26.26 | $26.26 | $26.26 |
Lucent Health
| Facility | 26 | $73.63 | $117.00 | $117.00 |
Providence
| Facility | 26 | $26.26 | $26.26 | $26.26 |