| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.15 | $75.15 | $124.00 | |
Aetna
| Professional | $75.15 | $75.15 | $87.17 | |
Cigna
| Facility | $80.88 | $80.88 | $80.88 | |
Cigna
| Professional | $80.88 | $80.88 | $80.88 | |
Lucent Health
| Facility | $81.52 | $164.84 | $300.14 | |
United
| Professional | $72.20 | $72.20 | $86.51 |