| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $71.45 | $71.45 | $71.45 | |
Cigna
| Facility | $90.10 | $90.10 | $90.10 | |
Cigna
| Professional | $71.45 | $89.31 | $90.10 | |
Providence
| Facility | $90.10 | $90.10 | $90.10 | |
Providence
| Professional | $55.93 | $62.14 | $77.68 | |
United
| Professional | $26.10 | $26.10 | $62.14 |