| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.81 | $2.81 | $4.92 | |
Aetna
| Professional | $2.81 | $2.81 | $2.81 | |
Cigna
| Professional | $99.00 | $99.00 | $99.00 | |
Lucent Health
| Facility | $90.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $108.32 | $108.32 | $108.32 |