| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,311.00 | $3,940.00 | $7,602.00 | |
Aetna
| Professional | $7.01 | $7.01 | $7.01 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $454.89 | $454.89 | $454.89 |