| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.40 | $52.16 | $90.21 | |
Aetna
| Professional | $42.48 | $42.48 | $50.09 | |
Cigna
| Facility | $42.48 | $42.48 | $42.48 | |
Cigna
| Professional | $42.48 | $42.48 | $42.48 | |
Lucent Health
| Facility | $75.00 | $212.40 | $213.85 | |
United
| Professional | $42.48 | $42.48 | $46.73 |