| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.19 | $549.54 | $549.54 | |
Aetna
| Professional | $107.15 | $128.82 | $199.53 | |
Cigna
| Professional | $181.97 | $181.97 | $229.09 | |
Providence
| Facility | $83.18 | $151.36 | $199.53 | |
Providence
| Professional | $158.49 | $158.49 | $158.49 | |
United
| Facility | $144.54 | $144.54 | $144.54 | |
United
| Professional | $67.61 | $67.61 | $95.50 |