| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.13 | $68.13 | $68.13 | |
Aetna
| Professional | $68.13 | $68.13 | $88.72 | |
Cigna
| Professional | $35.29 | $35.29 | $35.29 | |
Lucent Health
| Facility | $64.00 | $90.00 | $100.00 | |
Lucent Health
| Professional | $96.53 | $96.53 | $96.53 |