| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.15 | $21.15 | $37.01 | |
Aetna
| Professional | $20.38 | $21.15 | $21.66 | |
Lucent Health
| Facility | $80.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $96.82 | $96.82 | $114.66 |