| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.50 | $137.76 | $201.98 | |
Cigna
| Facility | $52.58 | $52.58 | $62.50 | |
Cigna
| Professional | $47.32 | $52.58 | $79.00 | |
Providence
| Facility | $19.50 | $52.58 | $201.98 | |
Providence
| Professional | $52.58 | $52.58 | $337.67 | |
United
| Professional | $192.63 | $198.38 | $328.18 |