| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $710.89 | $1,284.83 | $2,738.13 | |
Aetna
| Professional | $507.78 | $507.78 | $910.21 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $489.34 | $489.34 | $489.34 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |