| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.31 | $26.31 | $26.31 | |
Aetna
| Professional | $9.00 | $26.31 | $26.31 | |
Cigna
| Facility | $100.00 | $100.00 | $137.69 | |
Cigna
| Professional | $126.00 | $145.26 | $145.26 | |
Lucent Health
| Facility | $120.00 | $120.00 | $120.00 |