| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.80 | $20.80 | $20.80 | |
Cigna
| Facility | $26.23 | $26.23 | $26.23 | |
Cigna
| Professional | $20.65 | $25.81 | $26.23 | |
Providence
| Facility | $26.23 | $26.23 | $26.23 | |
Providence
| Professional | $16.28 | $16.28 | $26.23 | |
United
| Professional | $7.60 | $7.60 | $30.97 |