| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.37 | $126.40 | $221.87 | |
Aetna
| Professional | $97.37 | $120.56 | $157.32 | |
Aetna
| Professional | 25 | $26.28 | $128.72 | $147.68 |
Cigna
| Professional | $161.84 | $184.45 | $223.44 | |
Lucent Health
| Facility | $287.58 | $657.54 | $657.54 | |
United
| Professional | $92.55 | $140.99 | $259.10 |