| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $173.78 | $234.42 | |
Aetna
| Professional | $128.82 | $134.90 | $138.04 | |
Cigna
| Facility | $138.04 | $138.04 | $138.04 | |
Cigna
| Professional | $138.04 | $138.04 | $138.04 | |
Lucent Health
| Facility | $707.95 | $707.95 | $707.95 | |
United
| Professional | $316.23 | $331.13 | $331.13 |