| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.65 | $41.44 | $50.70 |
Cigna
| Facility | 26 | $51.06 | $51.06 | $51.06 |
Lucent Health
| Facility | 26 | $104.23 | $220.64 | $220.64 |
Providence
| Facility | 26 | $51.06 | $51.06 | $51.06 |