| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.02 | $0.02 | $0.02 | |
Aetna
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $38.77 | $38.77 | $38.77 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $1,698.45 | $1,698.45 | $1,698.45 |