| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $5.25 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Lucent Health
| Facility | $90.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $45.07 | $45.07 | $45.07 |