| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $47.86 | $53.70 | $72.44 |
Cigna
| Facility | 26 | $18.62 | $87.10 | $125.89 |
Lucent Health
| Facility | 26 | $478.63 | $478.63 | $478.63 |
Moda Health
| Facility | 26 | $47.86 | $53.70 | $63.10 |
Providence
| Facility | 26 | $18.62 | $87.10 | $125.89 |