| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $128.98 | $166.31 | $332.17 |
Cigna
| Professional | $256.70 | $860.63 | $1,450.91 | |
Cigna
| Professional | 26 | $48.29 | $147.25 | $248.25 |
Cigna
| Professional | TC | $189.86 | $713.38 | $1,202.66 |