| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.43 | $176.94 | $306.00 | |
Aetna
| Professional | $140.99 | $140.99 | $169.92 | |
Cigna
| Facility | $140.99 | $140.99 | $140.99 | |
Cigna
| Professional | $140.99 | $140.99 | $140.99 | |
Lucent Health
| Facility | $178.59 | $671.30 | $704.95 | |
United
| Professional | $140.99 | $149.44 | $180.47 |