| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.48 | $25.48 | $42.30 |
Cigna
| Facility | 26 | $35.40 | $35.40 | $35.40 |
Lucent Health
| Facility | 26 | $93.26 | $147.30 | $147.30 |
Providence
| Facility | 26 | $35.40 | $35.40 | $35.40 |