| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $34.49 | |
Aetna
| Professional | $20.00 | $34.49 | $34.49 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Lucent Health
| Facility | $64.00 | $950.51 | $950.51 | |
Lucent Health
| Professional | $122.28 | $122.28 | $122.28 |