| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $95.43 | $102.23 | $102.23 | |
Cigna
| Facility | $147.22 | $147.22 | $147.22 | |
Cigna
| Professional | $125.14 | $132.50 | $147.22 | |
Providence
| Facility | $44.01 | $60.51 | $94.47 | |
Providence
| Professional | $50.42 | $103.06 | $175.44 | |
United
| Professional | $121.71 | $147.53 | $164.13 |