| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $33.44 | $43.70 | $69.22 |
Cigna
| Facility | 26 | $60.17 | $60.17 | $60.17 |
Lucent Health
| Facility | 26 | $124.11 | $251.61 | $251.61 |
Providence
| Facility | 26 | $60.17 | $60.17 | $60.17 |