| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.82 | $178.80 | $343.29 | |
Aetna
| Professional | $85.82 | $143.04 | $143.04 | |
Cigna
| Professional | $131.75 | $131.75 | $164.68 | |
Providence
| Facility | $59.50 | $108.71 | $143.04 | |
Providence
| Professional | $93.83 | $114.43 | $114.43 | |
United
| Professional | $48.06 | $48.06 | $76.67 |