| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.24 | $45.00 | $69.94 |
Cigna
| Facility | 26 | $62.16 | $62.16 | $62.16 |
Lucent Health
| Facility | 26 | $126.99 | $263.10 | $263.10 |
Providence
| Facility | 26 | $62.16 | $62.16 | $62.16 |