| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.14 | $77.58 | $95.74 | |
Lucent Health
| Facility | $200.35 | $225.09 | $284.61 | |
Lucent Health
| Professional | $453.33 | $453.33 | $453.33 | |
United
| Professional | $77.12 | $98.85 | $168.70 |