| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $28.18 | $28.18 | $28.18 |
Cigna
| Facility | 26 | $5.62 | $26.30 | $38.02 |
Health Alliance Plan
| Facility | 26 | $20.89 | $51.29 | $57.54 |
Priority Health
| Facility | 26 | $5.62 | $26.30 | $38.02 |