| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.18 | $168.18 | $168.18 | |
Aetna
| Professional | $69.12 | $96.10 | $170.34 | |
Ambetter
| Professional | $44.25 | $95.58 | $155.80 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |