| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.87 | $214.87 | $376.02 | |
Aetna
| Professional | $189.02 | $214.87 | $225.83 | |
Cigna
| Professional | $119.00 | $119.00 | $119.00 | |
Lucent Health
| Facility | $402.98 | $1,206.97 | $1,225.03 | |
United
| Professional | $85.78 | $199.85 | $404.26 |