| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.86 | $17.86 | $31.26 | |
Aetna
| Professional | $17.86 | $17.86 | $17.86 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $46.22 | $46.22 | $46.22 | |
United
| Professional | $19.96 | $21.01 | $21.01 |