| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.15 | $73.36 | $79.93 | |
Cigna
| Facility | $105.16 | $105.16 | $105.16 | |
Cigna
| Professional | $89.39 | $89.39 | $106.25 | |
Providence
| Facility | $79.73 | $79.73 | $105.16 | |
Providence
| Professional | $89.39 | $91.05 | $106.25 | |
United
| Professional | $94.00 | $116.00 | $126.76 |