| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.16 | $21.16 | $21.16 | |
Cigna
| Facility | $26.68 | $26.68 | $26.68 | |
Cigna
| Professional | $21.06 | $26.33 | $26.68 | |
Providence
| Facility | $26.68 | $26.68 | $26.68 | |
Providence
| Professional | $16.55 | $16.55 | $26.68 | |
United
| Professional | $7.73 | $7.73 | $18.39 |