| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.08 | $64.54 | $5,191.45 | |
Aetna
| Professional | $31.08 | $31.09 | $32.02 | |
Cigna
| Facility | $19.98 | $19.98 | $19.98 | |
Cigna
| Professional | $19.98 | $19.98 | $19.98 | |
Lucent Health
| Facility | $113.55 | $218.60 | $218.60 | |
United
| Facility | $26.25 | $26.25 | $26.25 | |
United
| Professional | $40.09 | $40.09 | $81.78 |