| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.42 | $139.65 | $212.69 | |
Aetna
| Professional | $103.54 | $107.42 | $107.42 | |
Lucent Health
| Facility | $195.36 | $3,450.15 | $3,450.15 | |
United
| Professional | $110.01 | $129.41 | $129.41 |