| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.81 | $73.81 | $129.19 | |
Aetna
| Professional | $73.81 | $73.81 | $73.81 | |
Cigna
| Facility | $72.52 | $72.52 | $72.52 | |
Cigna
| Professional | $72.52 | $72.52 | $72.52 | |
Lucent Health
| Facility | $80.09 | $198.00 | $291.38 | |
United
| Professional | $73.81 | $77.70 | $87.11 |