| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $457.09 | $457.09 | $870.96 |
Cigna
| Facility | 26 | $602.56 | $707.95 | $1,122.02 |
Medica
| Facility | 26 | $1,819.70 | $2,238.72 | $2,238.72 |
Quartz
| Facility | 26 | $537.03 | $2,187.76 | $2,187.76 |