| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.06 | $74.06 | $74.06 | |
Cigna
| Facility | $93.39 | $93.39 | $93.39 | |
Cigna
| Professional | $73.93 | $92.41 | $93.39 | |
Providence
| Facility | $93.39 | $93.39 | $93.39 | |
Providence
| Professional | $57.97 | $57.97 | $93.39 | |
United
| Professional | $27.05 | $27.05 | $64.41 |