| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $233.06 | |
Aetna
| Professional | $141.25 | $141.25 | $141.25 | |
Cigna
| Facility | $148.50 | $148.50 | $148.50 | |
Cigna
| Professional | $148.50 | $148.50 | $148.50 | |
Lucent Health
| Facility | $151.01 | $230.49 | $230.49 | |
United
| Professional | $158.96 | $158.96 | $187.57 |