| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.43 | $98.82 | $170.90 | |
Aetna
| Professional | $78.93 | $78.93 | $94.90 | |
Cigna
| Facility | $78.93 | $78.93 | $78.93 | |
Cigna
| Professional | $78.93 | $78.93 | $78.93 | |
Lucent Health
| Facility | $104.99 | $394.65 | $398.70 | |
United
| Professional | $78.93 | $78.93 | $81.59 |