| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $26.99 | $26.99 | $32.34 | |
Lucent Health
| Facility | $80.00 | $90.00 | $100.00 | |
Lucent Health
| Professional | $79.48 | $81.87 | $81.87 | |
Providence
| Professional | $28.01 | $28.01 | $31.83 |