| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.98 | $64.57 | $112.20 |
Cigna
| Facility | 26 | $18.62 | $87.10 | $125.89 |
Lucent Health
| Facility | 26 | $489.78 | $489.78 | $489.78 |
Moda Health
| Facility | 26 | $48.98 | $56.23 | $64.57 |
Providence
| Facility | 26 | $18.62 | $87.10 | $125.89 |