| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.91 | $65.91 | $65.91 | |
Aetna
| Professional | $65.91 | $65.91 | $65.91 | |
BCBS
| Professional | $425.82 | $425.82 | $425.82 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $216.66 | $216.66 | $216.66 |