| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $676.08 | $676.08 | $676.08 | |
Aetna
| Professional | $676.08 | $676.08 | $707.95 | |
Cigna
| Facility | $537.03 | $537.03 | $537.03 | |
Cigna
| Professional | $457.09 | $537.03 | $537.03 | |
Lucent Health
| Facility | $64.57 | $3,548.13 | $3,548.13 |