| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.32 | $17.32 | $95.40 | |
Aetna
| Professional | $116.70 | $116.70 | $116.70 | |
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $125.13 | $125.13 | $125.13 |