| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $28.33 | $28.33 | $28.33 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $39.22 | $39.22 | $39.22 |