| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $57.75 | $57.75 | $72.19 | |
Lucent Health
| Facility | $75.00 | $152.29 | $152.29 | |
Lucent Health
| Professional | $180.14 | $194.36 | $202.14 | |
United
| Facility | $30.00 | $30.00 | $30.00 |