| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.61 | $40.04 | $65.45 | |
Aetna
| Professional | $28.61 | $28.61 | $37.27 | |
Cigna
| Facility | $28.61 | $28.61 | $28.61 | |
Cigna
| Professional | $28.61 | $28.61 | $28.61 | |
Lucent Health
| Facility | $168.40 | $255.00 | $255.00 | |
United
| Professional | $28.61 | $28.61 | $100.78 |