| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $2.21 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Cigna
| Professional | $309.58 | $309.58 | $309.58 | |
Lucent Health
| Facility | $100.00 | $100.00 | $316.79 | |
Lucent Health
| Professional | $407.30 | $407.30 | $407.30 |