| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.80 | $213.80 | $213.80 | |
Aetna
| Professional | $100.00 | $123.03 | $218.78 | |
Ambetter
| Professional | $56.23 | $81.28 | $141.25 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $9.77 | $9.77 | $9.77 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Professional | $218.78 | $218.78 | $218.78 |