| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.62 | $121.30 | $159.47 | |
Aetna
| Professional | $64.62 | $64.62 | $90.81 | |
Cigna
| Facility | $64.62 | $64.62 | $64.62 | |
Cigna
| Professional | $64.62 | $64.62 | $64.62 | |
Lucent Health
| Facility | $86.22 | $378.80 | $378.80 | |
United
| Professional | $64.62 | $64.62 | $134.05 |