| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $211.34 | $211.34 | $348.71 | |
Aetna
| Professional | $211.34 | $211.34 | $211.34 | |
Cigna
| Facility | $232.20 | $232.20 | $232.20 | |
Cigna
| Professional | $232.20 | $232.20 | $232.20 | |
Lucent Health
| Facility | $236.20 | $613.50 | $855.60 | |
United
| Facility | $248.63 | $410.24 | $534.54 | |
United
| Professional | $207.32 | $207.32 | $248.63 |