| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $336.05 | $336.05 | $336.05 | |
Aetna
| Professional | $336.05 | $336.05 | $729.83 | |
Cigna
| Facility | $405.00 | $405.00 | $405.00 | |
Cigna
| Professional | $344.25 | $405.00 | $413.10 | |
Lucent Health
| Facility | $80.00 | $347.75 | $374.50 |