| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $222.25 | $6,286.94 | $10,666.08 | |
Aetna
| Professional | $222.25 | $222.25 | $286.89 | |
Cigna
| Facility | $399.36 | $399.36 | $399.36 | |
Cigna
| Professional | $399.36 | $399.36 | $399.36 | |
Lucent Health
| Facility | $363.70 | $1,111.25 | $1,205.75 | |
United
| Professional | $222.25 | $251.14 | $427.88 |