| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $102.33 | $134.90 | |
Aetna
| Professional | $75.86 | $114.82 | $134.90 | |
Cigna
| Professional | $158.49 | $158.49 | $158.49 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Professional | $114.82 | $125.89 | $125.89 |