| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $105.50 | $112.73 | $112.73 | |
Cigna
| Facility | $165.63 | $165.63 | $165.63 | |
Cigna
| Professional | $140.79 | $149.07 | $165.63 | |
Providence
| Facility | $51.50 | $70.81 | $103.96 | |
Providence
| Professional | $58.94 | $113.41 | $184.87 | |
United
| Professional | $134.28 | $161.78 | $181.08 |