| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $78.23 | $89.97 | $108.43 |
Cigna
| Facility | 26 | $135.16 | $157.94 | $209.93 |
Medica
| Facility | 26 | $246.45 | $246.45 | $246.45 |
Quartz
| Facility | 26 | $123.45 | $246.45 | $246.45 |