| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $26.11 | $34.56 | $54.70 |
Cigna
| Facility | 26 | $48.31 | $48.31 | $48.31 |
Lucent Health
| Facility | 26 | $100.00 | $205.82 | $205.82 |
Providence
| Facility | 26 | $48.31 | $48.31 | $48.31 |