| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $117.89 | $117.89 | $117.89 | |
Lucent Health
| Facility | $80.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $77.04 | $77.04 | $77.04 |