| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $138.04 | $138.04 | $173.78 |
Cigna
| Facility | 26 | $28.84 | $131.83 | $190.55 |
Health Alliance Plan
| Facility | 26 | $89.13 | $208.93 | $245.47 |
Priority Health
| Facility | 26 | $28.84 | $131.83 | $190.55 |