| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.41 | $77.12 | $112.02 | |
Aetna
| Professional | $62.21 | $78.92 | $81.28 | |
Cigna
| Facility | $55.91 | $78.92 | $78.92 | |
Cigna
| Professional | $78.92 | $78.92 | $78.92 | |
Lucent Health
| Facility | $111.43 | $394.60 | $394.60 | |
United
| Professional | $78.92 | $83.66 | $103.66 |