| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $33.65 | $43.98 | $66.68 |
Cigna
| Facility | 26 | $60.00 | $60.00 | $60.00 |
Lucent Health
| Facility | 26 | $123.66 | $253.08 | $253.08 |
Providence
| Facility | 26 | $60.00 | $60.00 | $60.00 |