| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $70.79 | $72.44 | $72.44 |
Cigna
| Facility | 26 | $14.45 | $67.61 | $97.72 |
Health Alliance Plan
| Facility | 26 | $54.95 | $134.90 | $151.36 |
Priority Health
| Facility | 26 | $14.45 | $67.61 | $97.72 |