| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.16 | $67.16 | $110.81 | |
Aetna
| Professional | $67.15 | $67.16 | $67.16 | |
Cigna
| Facility | $74.02 | $74.02 | $74.02 | |
Cigna
| Professional | $74.02 | $74.02 | $74.02 | |
Lucent Health
| Facility | $75.06 | $158.02 | $296.29 | |
United
| Professional | $66.09 | $74.68 | $79.01 |