| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Facility | $30.80 | $30.80 | $30.80 | |
Cigna
| Professional | $19.32 | $19.32 | $19.32 | |
Lucent Health
| Facility | $80.00 | $90.00 | $100.00 | |
Lucent Health
| Professional | $69.75 | $69.75 | $69.75 |