| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $52.48 | $52.48 | $52.48 |
Cigna
| Facility | 26 | $10.96 | $50.12 | $72.44 |
Health Alliance Plan
| Facility | 26 | $52.48 | $138.04 | $154.88 |
Priority Health
| Facility | 26 | $10.96 | $50.12 | $72.44 |