| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $23.99 | $23.99 | |
Aetna
| Professional | $8.51 | $23.99 | $23.99 | |
Cigna
| Facility | $120.23 | $120.23 | $147.91 | |
Cigna
| Professional | $58.88 | $58.88 | $95.50 | |
Lucent Health
| Facility | $25.70 | $125.89 | $125.89 |