| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.86 | $19.86 | $19.86 | |
Cigna
| Facility | $25.04 | $25.04 | $32.50 | |
Cigna
| Professional | $19.82 | $24.78 | $25.04 | |
Providence
| Facility | $25.04 | $25.04 | $32.50 | |
Providence
| Professional | $15.54 | $15.54 | $25.04 | |
United
| Professional | $7.25 | $7.25 | $17.27 |