| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.62 | $18.62 | $32.59 | |
Aetna
| Professional | $18.62 | $18.62 | $18.62 | |
Cigna
| Facility | $17.52 | $17.52 | $17.52 | |
Cigna
| Professional | $17.52 | $17.52 | $17.52 | |
Lucent Health
| Facility | $23.77 | $100.00 | $100.00 | |
United
| Facility | $11.97 | $11.97 | $11.97 | |
United
| Professional | $18.62 | $18.62 | $21.97 |