| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.38 | $95.50 | $95.50 | |
Aetna
| Professional | $114.82 | $676.08 | $724.44 | |
Cigna
| Professional | $79.43 | $79.43 | $79.43 | |
Lucent Health
| Facility | $165.96 | $165.96 | $165.96 | |
Lucent Health
| Professional | $125.89 | $125.89 | $125.89 |