| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.80 | $15.80 | $15.80 | |
Cigna
| Facility | $19.92 | $19.92 | $19.92 | |
Cigna
| Professional | $15.69 | $19.62 | $19.92 | |
Providence
| Facility | $19.92 | $19.92 | $19.92 | |
Providence
| Professional | $12.37 | $13.74 | $17.18 | |
United
| Professional | $5.77 | $5.77 | $15.27 |