| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.66 | $63.10 | $109.65 | |
Aetna
| Professional | $61.66 | $61.66 | $74.13 | |
BCBS
| Professional | $63.10 | $63.10 | $70.79 | |
Cigna
| Facility | $63.10 | $63.10 | $63.10 | |
Cigna
| Professional | $63.10 | $63.10 | $63.10 | |
Lucent Health
| Facility | $263.03 | $263.03 | $263.03 | |
Lucent Health
| Professional | $288.40 | $371.54 | $371.54 | |
United
| Professional | $69.18 | $83.18 | $125.89 |