| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.66 | $11.66 | $11.66 | |
Aetna
| Professional | $11.66 | $14.51 | $125.08 | |
BCBS
| Professional | $73.70 | $115.21 | $176.97 | |
Cigna
| Professional | $19.00 | $25.56 | $47.36 | |
Lucent Health
| Facility | $228.62 | $228.62 | $245.30 | |
Lucent Health
| Professional | $806.50 | $806.50 | $921.98 | |
Optum
| Professional | $23.82 | $23.82 | $29.27 | |
United
| Professional | $23.82 | $134.63 | $255.08 |