| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.90 | $42.90 | $70.79 | |
Aetna
| Professional | $42.90 | $42.90 | $42.90 | |
Cigna
| Facility | $47.11 | $47.11 | $47.11 | |
Cigna
| Professional | $47.11 | $47.11 | $47.11 | |
Lucent Health
| Facility | $96.07 | $262.33 | $262.33 | |
United
| Professional | $50.47 | $50.47 | $59.55 |