| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $315.56 | $918.00 | $3,685.98 | |
Aetna
| Professional | $35.74 | $60.88 | $60.88 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $45.06 | $45.06 | $45.06 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |