| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.89 | $42.89 | $66.26 |
Cigna
| Facility | 26 | $59.30 | $59.30 | $59.30 |
Lucent Health
| Facility | 26 | $123.03 | $251.23 | $251.23 |
Providence
| Facility | 26 | $59.30 | $59.30 | $59.30 |