| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.91 | $158.91 | $278.11 | |
Aetna
| Professional | $158.91 | $158.91 | $163.68 | |
BCBS
| Professional | $158.91 | $172.41 | $179.90 | |
Cigna
| Facility | $158.91 | $158.91 | $158.91 | |
Cigna
| Professional | $158.91 | $158.91 | $158.91 | |
Lucent Health
| Facility | $179.91 | $654.50 | $654.50 | |
United
| Professional | $63.57 | $158.91 | $174.81 |