| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.93 | $208.93 | $371.54 | |
Aetna
| Professional | $208.93 | $208.93 | $245.47 | |
Ambetter
| Professional | $89.13 | $131.83 | $218.78 | |
Cigna
| Facility | $251.19 | $251.19 | $251.19 | |
Cigna
| Professional | $251.19 | $251.19 | $251.19 | |
Lucent Health
| Facility | $741.31 | $741.31 | $741.31 | |
United
| Professional | $208.93 | $223.87 | $269.15 |