| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,398.83 | $3,715.35 | $13,803.84 | |
Aetna
| Professional | $2,398.83 | $2,398.83 | $4,897.79 | |
Lucent Health
| Facility | $64.57 | $8,317.64 | $8,317.64 | |
Lucent Health
| Professional | $7,413.10 | $7,413.10 | $7,413.10 |