| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.73 | $19.73 | $7,028.74 | |
Aetna
| Professional | $19.02 | $19.73 | $20.21 | |
Lucent Health
| Facility | $80.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $90.36 | $90.36 | $107.01 |