| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.51 | $63.33 | $98.43 |
Cigna
| Facility | 26 | $87.50 | $87.50 | $87.50 |
Lucent Health
| Facility | 26 | $180.94 | $371.26 | $371.26 |
Providence
| Facility | 26 | $87.50 | $87.50 | $87.50 |