| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.44 | $30.44 | $50.23 | |
Aetna
| Professional | $30.44 | $30.44 | $30.44 | |
Cigna
| Facility | $33.42 | $33.42 | $33.42 | |
Cigna
| Professional | $33.42 | $33.42 | $33.42 | |
Lucent Health
| Facility | $56.37 | $757.05 | $757.05 | |
United
| Professional | $30.74 | $30.74 | $36.27 |