| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $98.32 | $100.41 | $100.41 | |
Cigna
| Facility | $144.07 | $144.07 | $144.07 | |
Cigna
| Professional | $122.46 | $129.66 | $144.07 | |
Providence
| Facility | $58.14 | $58.14 | $144.07 | |
Providence
| Professional | $122.46 | $144.07 | $202.71 | |
United
| Professional | $133.10 | $146.15 | $167.04 |