| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.47 | $104.94 | $675.00 | |
Aetna
| Professional | $53.07 | $53.08 | $64.23 | |
Cigna
| Facility | $45.90 | $45.90 | $45.90 | |
Cigna
| Professional | $45.90 | $45.90 | $45.90 | |
Lucent Health
| Facility | $75.00 | $282.33 | $282.33 | |
United
| Professional | $45.90 | $53.08 | $53.08 |