| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $327.43 | $327.43 | $327.43 | |
Aetna
| Professional | $327.43 | $327.43 | $390.48 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $310.31 | $310.31 | $310.31 | |
Lucent Health
| Facility | $65.00 | $100.00 | $100.00 |