| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $41.47 | $54.09 | $84.29 |
Cigna
| Facility | 26 | $74.83 | $74.83 | $74.83 |
Lucent Health
| Facility | 26 | $155.65 | $318.20 | $318.20 |
Providence
| Facility | 26 | $74.83 | $74.83 | $74.83 |