| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.95 | $33.15 | $3,906.00 | |
Aetna
| Professional | $22.01 | $22.02 | $22.93 | |
Cigna
| Facility | $22.02 | $22.02 | $22.02 | |
Cigna
| Professional | $22.02 | $22.02 | $22.02 | |
Lucent Health
| Facility | $75.00 | $110.10 | $110.10 | |
United
| Professional | $22.02 | $22.02 | $37.26 |