| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Cigna
| Professional | $425.00 | $425.00 | $425.00 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Providence
| Professional | $425.00 | $425.00 | $425.00 |