| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.79 | $70.79 | $70.79 | |
Aetna
| Professional | $70.79 | $70.79 | $173.78 | |
BCBS
| Professional | $125.89 | $125.89 | $125.89 | |
Lucent Health
| Facility | $257.04 | $257.04 | $257.04 | |
Lucent Health
| Professional | $257.04 | $407.38 | $407.38 |