| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.52 | $176.45 | $195.47 | |
Aetna
| Professional | $134.83 | $134.83 | $148.31 | |
Cigna
| Facility | $148.32 | $148.32 | $148.32 | |
Cigna
| Professional | $148.32 | $148.32 | $148.32 | |
Lucent Health
| Facility | $150.69 | $317.24 | $566.78 | |
United
| Professional | $132.43 | $132.43 | $158.62 |