| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $263.03 | $275.42 | $1,096.48 | |
Aetna
| Professional | $229.09 | $275.42 | $398.11 | |
Lucent Health
| Facility | $1,659.59 | $1,659.59 | $1,659.59 | |
Lucent Health
| Professional | $1,737.80 | $2,630.27 | $2,630.27 | |
United
| Facility | $125.89 | $346.74 | $346.74 | |
United
| Professional | $147.91 | $208.93 | $346.74 |