| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.97 | $107.43 | $123.03 | |
Cigna
| Facility | $128.30 | $128.30 | $128.30 | |
Cigna
| Professional | $83.40 | $115.47 | $137.59 | |
Providence
| Facility | $60.28 | $96.03 | $127.54 | |
Providence
| Professional | $83.40 | $115.47 | $139.52 | |
United
| Professional | $147.85 | $184.81 | $222.32 |