| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $37.95 | $49.58 | $76.15 |
Cigna
| Facility | 26 | $68.56 | $68.56 | $68.56 |
Lucent Health
| Facility | 26 | $141.08 | $287.95 | $287.95 |
Providence
| Facility | 26 | $68.56 | $68.56 | $68.56 |