| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.16 | $10.27 | $17.78 | |
Aetna
| Professional | $10.26 | $10.27 | $10.58 | |
Cigna
| Facility | $10.27 | $10.27 | $10.27 | |
Cigna
| Professional | $10.27 | $10.27 | $10.27 | |
Lucent Health
| Facility | $75.00 | $129.60 | $129.60 | |
United
| Professional | $10.27 | $10.27 | $12.75 |