| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.12 | $776.12 | $1,389.25 | |
Aetna
| Professional | $748.07 | $776.12 | $776.12 | |
Cigna
| Facility | $794.83 | $794.83 | $794.83 | |
Cigna
| Professional | $794.83 | $794.83 | $794.83 | |
Lucent Health
| Facility | $888.34 | $3,853.40 | $3,853.40 |