| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.62 | $588.62 | $1,030.08 | |
Aetna
| Professional | $588.62 | $588.62 | $588.62 | |
Cigna
| Professional | $781.33 | $781.33 | $781.33 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |