| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.80 | $135.33 | $719.82 | |
Aetna
| Professional | $102.14 | $102.14 | $121.70 | |
Cigna
| Professional | $119.90 | $119.90 | $119.90 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |