| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.86 | $97.32 | $159.08 | |
Aetna
| Professional | $75.97 | $75.97 | $90.58 | |
Cigna
| Facility | $75.97 | $75.97 | $75.97 | |
Cigna
| Professional | $75.97 | $75.97 | $75.97 | |
Lucent Health
| Facility | $93.68 | $465.60 | $624.26 | |
United
| Professional | $75.97 | $75.97 | $106.13 |