| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $336.06 | $336.06 | $336.06 | |
Aetna
| Professional | $84.02 | $84.02 | $84.02 | |
Cigna
| Facility | $72.81 | $72.81 | $72.81 | |
Cigna
| Professional | $128.44 | $128.44 | $160.55 | |
Providence
| Facility | $72.81 | $72.81 | $72.81 | |
Providence
| Professional | $91.86 | $112.02 | $112.02 | |
United
| Professional | $47.05 | $47.05 | $67.20 |