| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $503.29 | $503.29 | $503.29 | |
Aetna
| Professional | $503.29 | $503.29 | $674.80 | |
Cigna
| Facility | $390.00 | $390.00 | $390.00 | |
Cigna
| Professional | $331.50 | $390.00 | $390.00 | |
Lucent Health
| Facility | $80.00 | $365.95 | $394.10 |