| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.73 | $41.73 | $41.73 | |
Cigna
| Facility | $66.25 | $66.25 | $78.75 | |
Cigna
| Professional | $66.25 | $66.25 | $66.25 | |
Providence
| Facility | $66.25 | $66.25 | $78.75 | |
Providence
| Professional | $66.25 | $74.83 | $88.04 | |
United
| Professional | $60.69 | $70.22 | $83.31 |