| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $180.20 | $180.20 | $297.33 | |
Aetna
| Professional | $180.20 | $180.20 | $180.20 | |
Cigna
| Facility | $203.81 | $203.81 | $203.81 | |
Cigna
| Professional | $203.81 | $203.81 | $203.81 | |
Lucent Health
| Facility | $288.08 | $616.95 | $735.08 | |
United
| Professional | $181.97 | $181.97 | $218.36 |