| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.65 | $23.65 | $42.33 | |
Aetna
| Professional | $22.79 | $23.65 | $24.22 | |
Cigna
| Professional | $4.04 | $4.04 | $4.04 | |
Lucent Health
| Facility | $80.00 | $100.00 | $103.73 | |
Lucent Health
| Professional | $103.73 | $105.11 | $124.47 |