| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $588.84 | $691.83 | |
Aetna
| Professional | $489.78 | $588.84 | $812.83 | |
Lucent Health
| Facility | $3,548.13 | $3,548.13 | $3,548.13 | |
Lucent Health
| Professional | $3,715.35 | $5,623.41 | $5,623.41 | |
United
| Facility | $269.15 | $741.31 | $741.31 | |
United
| Professional | $309.03 | $446.68 | $741.31 |