| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.51 | $101.65 | $166.11 | |
Aetna
| Professional | $104.67 | $104.67 | $138.27 | |
Cigna
| Facility | $115.07 | $115.07 | $115.07 | |
Cigna
| Professional | $115.07 | $115.07 | $115.07 | |
Lucent Health
| Facility | $112.51 | $236.86 | $431.25 | |
United
| Professional | $102.74 | $102.74 | $123.14 |