| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $163.01 | $229.88 | $229.88 |
Cigna
| Facility | 26 | $283.85 | $331.70 | $440.86 |
Medica
| Facility | 26 | $531.37 | $531.37 | $531.37 |
Quartz
| Facility | 26 | $258.85 | $531.37 | $531.37 |