| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.81 | $101.15 | $154.06 | |
Aetna
| Professional | $75.00 | $77.81 | $77.81 | |
Cigna
| Facility | $79.50 | $79.50 | $79.50 | |
Cigna
| Professional | $79.50 | $79.50 | $79.50 | |
Lucent Health
| Facility | $141.37 | $403.61 | $403.61 | |
United
| Professional | $77.09 | $90.69 | $90.69 |