| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.94 | $29.91 | $41.28 | |
Aetna
| Professional | $19.22 | $19.94 | $19.94 | |
Cigna
| Facility | $20.43 | $20.43 | $20.43 | |
Cigna
| Professional | $20.43 | $20.43 | $20.43 | |
Lucent Health
| Facility | $80.00 | $99.90 | $99.90 |