| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.60 | $139.97 | $2,658.73 | |
Aetna
| Professional | $118.61 | $118.61 | $167.23 | |
Cigna
| Professional | $14.23 | $14.23 | $14.23 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |