| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.46 | $24.46 | $24.46 | |
Aetna
| Professional | $8.00 | $24.46 | $24.46 | |
Cigna
| Facility | $120.00 | $120.00 | $148.91 | |
Cigna
| Professional | $58.98 | $58.98 | $95.16 | |
Lucent Health
| Facility | $80.00 | $117.55 | $117.55 |