| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.99 | $412.99 | $412.99 | |
Aetna
| Professional | $391.55 | $412.99 | $412.99 | |
Cigna
| Facility | $296.00 | $296.00 | $296.00 | |
Cigna
| Professional | $251.60 | $251.60 | $296.00 | |
Lucent Health
| Facility | $64.00 | $90.00 | $100.00 |