| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $186.21 | $186.21 | $186.21 |
Cigna
| Facility | 26 | $38.02 | $177.83 | $257.04 |
Health Alliance Plan
| Facility | 26 | $173.78 | $426.58 | $512.86 |
Priority Health
| Facility | 26 | $38.02 | $177.83 | $257.04 |