| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.72 | $69.72 | $122.01 | |
Aetna
| Professional | $67.20 | $69.72 | $71.40 | |
Cigna
| Facility | $71.40 | $71.40 | $71.40 | |
Cigna
| Professional | $71.40 | $71.40 | $71.40 | |
Lucent Health
| Facility | $118.87 | $339.39 | $339.39 | |
Lucent Health
| Professional | $429.65 | $429.65 | $523.28 | |
United
| Professional | $75.81 | $79.80 | $79.80 |