| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.34 | $107.43 | $123.03 | |
Cigna
| Facility | $15.77 | $15.77 | $15.77 | |
Cigna
| Professional | $10.25 | $14.19 | $137.59 | |
Providence
| Facility | $15.77 | $102.36 | $126.34 | |
Providence
| Professional | $10.25 | $14.19 | $139.52 | |
United
| Professional | $150.93 | $181.73 | $222.32 |