| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.13 | $49.13 | $49.13 | |
Cigna
| Facility | $74.14 | $74.14 | $74.14 | |
Cigna
| Professional | $63.02 | $74.14 | $74.14 | |
Providence
| Facility | $11.71 | $18.73 | $58.90 | |
Providence
| Professional | $10.61 | $14.05 | $88.66 | |
United
| Professional | $19.23 | $21.25 | $22.92 |