| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $21.03 | $21.03 | $21.03 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $29.12 | $29.12 | $29.12 |