| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.47 | $168.45 | $282.36 | |
Aetna
| Professional | $129.47 | $129.47 | $156.79 | |
Cigna
| Facility | $129.47 | $129.47 | $129.47 | |
Cigna
| Professional | $129.47 | $129.47 | $129.47 | |
Lucent Health
| Facility | $172.23 | $647.40 | $647.50 | |
United
| Professional | $129.47 | $129.47 | $129.47 |