| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.50 | $30.04 | $56.20 | |
Cigna
| Facility | $52.58 | $52.58 | $52.58 | |
Cigna
| Professional | $30.48 | $52.58 | $79.00 | |
Providence
| Facility | $8.96 | $33.27 | $56.20 | |
Providence
| Professional | $30.48 | $52.58 | $79.00 | |
United
| Professional | $2.67 | $18.00 | $31.05 |