| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.40 | $14.40 | $14.40 | |
Cigna
| Facility | $34.92 | $34.92 | $34.92 | |
Cigna
| Professional | $5.25 | $5.25 | $5.25 | |
Lucent Health
| Facility | $64.00 | $100.00 | $112.62 | |
Lucent Health
| Professional | $120.06 | $120.06 | $120.06 |