| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.65 | $162.05 | $246.81 | |
Aetna
| Professional | $120.14 | $124.65 | $124.65 | |
Cigna
| Facility | $63.43 | $63.43 | $63.43 | |
Cigna
| Professional | $63.43 | $63.43 | $63.43 | |
Lucent Health
| Facility | $150.18 | $663.30 | $663.30 | |
United
| Professional | $125.15 | $125.15 | $127.65 |