| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $24.62 | $31.79 | $49.84 |
Cigna
| Facility | 26 | $44.41 | $44.41 | $44.41 |
Lucent Health
| Facility | 26 | $92.41 | $191.09 | $191.09 |
Providence
| Facility | 26 | $44.41 | $44.41 | $44.41 |