| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $247.40 | $247.40 | $247.40 | |
Aetna
| Professional | $173.68 | $247.40 | $247.40 | |
Cigna
| Facility | $170.83 | $170.83 | $170.83 | |
Cigna
| Professional | $145.21 | $170.83 | $170.83 | |
Lucent Health
| Facility | $64.00 | $90.00 | $100.00 |