| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.47 | $909.90 | $969.00 | |
Aetna
| Professional | $137.47 | $137.47 | $529.04 | |
Cigna
| Professional | $165.00 | $165.00 | $165.00 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $54.63 | $54.63 | $54.63 |