| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.00 | $149.61 | $245.00 | |
Aetna
| Professional | $100.19 | $140.00 | $162.43 | |
Cigna
| Professional | $203.28 | $203.28 | $234.70 | |
Lucent Health
| Facility | $267.85 | $369.63 | $369.63 | |
Lucent Health
| Professional | $433.05 | $433.05 | $433.05 |