| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.50 | $125.50 | $207.08 | |
Aetna
| Professional | $125.50 | $125.50 | $125.50 | |
Cigna
| Facility | $137.94 | $137.94 | $137.94 | |
Cigna
| Professional | $137.94 | $137.94 | $137.94 | |
Lucent Health
| Facility | $167.50 | $532.45 | $532.45 | |
United
| Professional | $147.65 | $147.65 | $174.23 |