| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $182.28 | $182.28 | $182.28 | |
Cigna
| Facility | $267.11 | $267.11 | $267.11 | |
Cigna
| Professional | $140.69 | $227.04 | $267.11 | |
Providence
| Facility | $142.33 | $191.25 | $267.11 | |
Providence
| Professional | $140.69 | $267.11 | $375.08 | |
United
| Professional | $294.16 | $332.77 | $360.95 |