| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.16 | $69.97 | $76.76 | |
Cigna
| Facility | $101.48 | $101.48 | $101.48 | |
Cigna
| Professional | $101.48 | $101.48 | $101.48 | |
Providence
| Facility | $61.98 | $64.95 | $101.48 | |
Providence
| Professional | $58.73 | $93.21 | $109.66 | |
United
| Professional | $69.25 | $70.80 | $177.59 |