| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $562.34 | $660.69 | |
Aetna
| Professional | $467.74 | $562.34 | $812.83 | |
Lucent Health
| Facility | $3,388.44 | $3,388.44 | $3,388.44 | |
Lucent Health
| Professional | $3,548.13 | $5,370.32 | $5,370.32 | |
United
| Facility | $257.04 | $707.95 | $707.95 | |
United
| Professional | $295.12 | $426.58 | $707.95 |