| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $182.88 | $300.99 | $300.99 | |
Cigna
| Facility | $216.10 | $216.10 | $256.88 | |
Cigna
| Professional | $183.69 | $194.49 | $216.10 | |
Providence
| Facility | $86.64 | $216.10 | $256.88 | |
Providence
| Professional | $183.69 | $216.10 | $303.32 | |
United
| Professional | $197.07 | $198.65 | $477.89 |