| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.62 | $60.62 | $60.62 | |
Cigna
| Facility | $76.43 | $76.43 | $76.43 | |
Cigna
| Professional | $60.71 | $75.89 | $76.43 | |
Providence
| Facility | $76.43 | $76.43 | $76.43 | |
Providence
| Professional | $47.44 | $47.44 | $76.43 | |
United
| Professional | $22.14 | $22.14 | $52.71 |