| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $238.98 | $238.98 | $238.98 | |
Aetna
| Professional | $141.36 | $238.98 | $238.98 | |
Cigna
| Facility | $180.13 | $180.13 | $180.13 | |
Cigna
| Professional | $153.11 | $180.13 | $180.13 | |
Lucent Health
| Facility | $64.00 | $90.00 | $100.00 |