| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.27 | $124.54 | $234.09 | |
Aetna
| Professional | $101.77 | $124.54 | $157.41 | |
Aetna
| Professional | 25 | $24.50 | $68.90 | $175.00 |
Cigna
| Professional | $143.94 | $187.14 | $228.75 | |
Lucent Health
| Facility | $330.02 | $761.19 | $761.19 | |
United
| Professional | $105.04 | $146.35 | $268.50 |