| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $40.81 | $53.25 | $83.47 |
Cigna
| Facility | 26 | $74.48 | $74.48 | $74.48 |
Lucent Health
| Facility | 26 | $154.38 | $314.55 | $314.55 |
Providence
| Facility | 26 | $74.48 | $74.48 | $74.48 |