| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $49.38 | $64.23 | $97.94 |
Cigna
| Facility | 26 | $87.95 | $87.95 | $87.95 |
Lucent Health
| Facility | 26 | $181.03 | $375.01 | $375.01 |
Providence
| Facility | 26 | $87.95 | $87.95 | $87.95 |