| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.77 | $270.36 | $519.09 | |
Aetna
| Professional | $129.77 | $216.29 | $216.29 | |
Cigna
| Professional | $199.07 | $199.07 | $248.83 | |
Providence
| Facility | $89.98 | $164.38 | $216.29 | |
Providence
| Professional | $141.88 | $141.88 | $173.03 | |
United
| Professional | $72.67 | $72.67 | $103.82 |