| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $61.80 | $81.26 | $128.47 |
Cigna
| Facility | 26 | $113.90 | $113.90 | $113.90 |
Lucent Health
| Facility | 26 | $229.64 | $454.15 | $481.98 |
Providence
| Facility | 26 | $113.90 | $113.90 | $113.90 |