| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.80 | $119.61 | $179.52 | |
Aetna
| Professional | $119.61 | $119.61 | $119.61 | |
Cigna
| Facility | $131.35 | $131.35 | $131.35 | |
Cigna
| Professional | $131.35 | $131.35 | $131.35 | |
Lucent Health
| Facility | $121.60 | $256.00 | $480.00 | |
United
| Professional | $117.28 | $117.28 | $140.74 |