| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.19 | $169.96 | $280.43 | |
Aetna
| Professional | $169.96 | $169.96 | $237.94 | |
Cigna
| Facility | $186.76 | $186.76 | $186.76 | |
Cigna
| Professional | $186.76 | $186.76 | $186.76 | |
Lucent Health
| Facility | $333.64 | $507.70 | $707.51 | |
United
| Professional | $166.75 | $188.43 | $199.95 |