| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.67 | $65.67 | $108.36 | |
Aetna
| Professional | $65.67 | $65.67 | $65.67 | |
Cigna
| Facility | $72.25 | $72.25 | $72.25 | |
Cigna
| Professional | $72.25 | $72.25 | $72.25 | |
Lucent Health
| Facility | $86.62 | $154.52 | $289.73 | |
United
| Professional | $73.40 | $73.40 | $86.61 |