| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $14.77 | $19.73 | $29.62 |
Cigna
| Facility | 26 | $26.68 | $26.68 | $26.68 |
Lucent Health
| Facility | 26 | $61.36 | $110.49 | $110.49 |
Providence
| Facility | 26 | $26.68 | $26.68 | $26.68 |