| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $275.39 | $275.39 | $275.39 | |
Aetna
| Professional | $275.39 | $275.39 | $275.39 | |
Cigna
| Facility | $302.39 | $302.39 | $302.39 | |
Cigna
| Professional | $302.39 | $302.39 | $302.39 | |
Lucent Health
| Facility | $307.80 | $648.00 | $1,215.00 | |
United
| Facility | $0.02 | $0.02 | $0.02 | |
United
| Professional | $247.34 | $247.34 | $324.00 |