| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $131.25 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Professional | $98.27 | $98.27 | $98.27 | |
Lucent Health
| Facility | $100.00 | $100.00 | $146.57 | |
Lucent Health
| Professional | $188.44 | $188.44 | $188.44 |