| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $70.79 | $79.43 | $107.15 |
Cigna
| Facility | 26 | $28.84 | $131.83 | $190.55 |
Lucent Health
| Facility | 26 | $707.95 | $707.95 | $707.95 |
Moda Health
| Facility | 26 | $70.79 | $79.43 | $93.33 |
Providence
| Facility | 26 | $28.84 | $131.83 | $190.55 |