| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $115.85 | $160.66 | $160.66 |
Cigna
| Facility | 26 | $200.95 | $234.83 | $360.23 |
Medica
| Facility | 26 | $345.15 | $345.15 | $345.15 |
Quartz
| Facility | 26 | $183.20 | $345.15 | $345.15 |