| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $371.54 | $371.54 | $416.87 | |
Cigna
| Facility | $1,412.54 | $1,412.54 | $1,412.54 | |
Cigna
| Professional | $9,549.93 | $10,000.00 | $12,022.64 | |
Lucent Health
| Facility | $1,412.54 | $1,412.54 | $1,412.54 |