| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $58.80 | $77.41 | $119.39 |
Cigna
| Facility | 26 | $106.76 | $106.76 | $106.76 |
Lucent Health
| Facility | 26 | $217.55 | $1,072.58 | $1,072.58 |
Providence
| Facility | 26 | $106.76 | $106.76 | $106.76 |