| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.04 | $134.91 | $134.91 | |
Aetna
| Professional | $87.04 | $137.05 | $191.93 | |
Lucent Health
| Facility | $386.51 | $1,093.11 | $1,093.11 | |
Lucent Health
| Professional | $1,044.82 | $1,066.36 | $1,723.73 |