| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.50 | $93.99 | $93.99 | |
Aetna
| Professional | $23.50 | $23.50 | $23.50 | |
Cigna
| Facility | $20.36 | $20.36 | $20.36 | |
Cigna
| Professional | $35.93 | $35.93 | $44.91 | |
Providence
| Facility | $20.36 | $20.36 | $31.33 | |
Providence
| Professional | $25.69 | $31.33 | $31.33 | |
United
| Professional | $13.16 | $13.16 | $18.80 |