| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.66 | $17.66 | $17.66 | |
Aetna
| Professional | $17.66 | $17.66 | $42.65 | |
Cigna
| Professional | $19.50 | $19.50 | $19.50 | |
Lucent Health
| Facility | $87.40 | $90.90 | $90.90 | |
Lucent Health
| Professional | $56.12 | $56.12 | $56.12 |