| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $787.50 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $371.73 | $371.73 | $371.73 | |
Lucent Health
| Facility | $793.40 | $2,384.42 | $2,384.42 | |
United
| Professional | $411.98 | $555.82 | $1,169.59 |