| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.39 | $57.71 | $87.89 | |
Aetna
| Professional | $42.78 | $44.39 | $44.39 | |
Cigna
| Facility | $45.46 | $45.46 | $45.46 | |
Cigna
| Professional | $45.46 | $45.46 | $45.46 | |
Lucent Health
| Facility | $80.00 | $236.20 | $236.20 |