| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.69 | $6.87 | $11.88 | |
Aetna
| Professional | $4.69 | $4.69 | $6.59 | |
Cigna
| Facility | $4.69 | $4.69 | $4.69 | |
Cigna
| Professional | $4.69 | $4.69 | $4.69 | |
Lucent Health
| Facility | $75.00 | $85.00 | $85.00 | |
United
| Professional | $4.69 | $4.69 | $18.39 |