| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.84 | $28.39 | $43.24 | |
Aetna
| Professional | $21.05 | $21.84 | $21.84 | |
Cigna
| Facility | $21.05 | $21.05 | $21.05 | |
Cigna
| Professional | $21.05 | $21.05 | $21.05 | |
Lucent Health
| Facility | $39.84 | $113.76 | $113.76 | |
United
| Professional | $21.05 | $21.05 | $22.36 |