| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $65.70 | $80.95 | $141.93 |
Cigna
| Facility | 26 | $114.78 | $114.78 | $114.78 |
Lucent Health
| Facility | 26 | $239.35 | $488.54 | $488.54 |
Providence
| Facility | 26 | $114.78 | $114.78 | $114.78 |