| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.22 | $16.22 | $28.84 | |
Aetna
| Professional | $15.85 | $15.85 | $16.22 | |
Ambetter
| Professional | $11.22 | $11.22 | $11.22 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $12.88 | $13.80 | $15.85 | |
United
| Professional | $12.88 | $13.49 | $15.49 |