| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.18 | $125.89 | $125.89 | |
Aetna
| Professional | $125.89 | $125.89 | $138.04 | |
Lucent Health
| Facility | $537.03 | $537.03 | $537.03 | |
United
| Professional | $147.91 | $147.91 | $173.78 |