| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $98.95 | $101.89 | $114.85 | |
Cigna
| Facility | $148.28 | $148.28 | $148.28 | |
Cigna
| Professional | $133.44 | $148.28 | $148.28 | |
Providence
| Facility | $61.18 | $88.71 | $148.28 | |
Providence
| Professional | $103.85 | $148.28 | $207.88 | |
United
| Professional | $101.55 | $121.54 | $138.66 |