| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $42.13 | $46.34 | |
Cigna
| Facility | $74.56 | $74.56 | $74.56 | |
Cigna
| Professional | $59.10 | $73.88 | $74.56 | |
Providence
| Facility | $74.56 | $74.56 | $74.56 | |
Providence
| Professional | $42.13 | $42.97 | $74.56 | |
United
| Professional | $17.66 | $17.73 | $42.22 |