| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.05 | $24.05 | $47.62 | |
Aetna
| Professional | $23.18 | $24.05 | $24.05 | |
Cigna
| Facility | $24.63 | $24.63 | $24.63 | |
Cigna
| Professional | $24.63 | $24.63 | $24.63 | |
Lucent Health
| Facility | $80.00 | $125.25 | $125.25 |