| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.39 | $18.39 | $18.39 | |
Cigna
| Facility | $23.20 | $23.20 | $23.20 | |
Cigna
| Professional | $18.17 | $22.72 | $23.20 | |
Providence
| Facility | $23.20 | $23.20 | $23.20 | |
Providence
| Professional | $14.40 | $14.40 | $23.20 | |
United
| Professional | $6.72 | $6.72 | $16.00 |