| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.90 | $88.24 | $134.88 | |
Aetna
| Professional | $67.88 | $68.59 | $76.14 | |
Cigna
| Facility | $14.00 | $14.00 | $14.00 | |
Cigna
| Professional | $14.00 | $14.00 | $14.00 | |
Lucent Health
| Facility | $140.72 | $401.76 | $401.76 | |
United
| Professional | $13.60 | $16.00 | $16.00 |