| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.71 | $16.52 | $25.25 | |
Aetna
| Professional | $12.71 | $12.84 | $14.25 | |
Cigna
| Facility | $30.15 | $30.15 | $30.15 | |
Cigna
| Professional | $30.15 | $30.15 | $30.15 | |
Lucent Health
| Facility | $26.35 | $100.00 | $100.00 | |
United
| Professional | $16.63 | $17.50 | $17.50 |