| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.37 | $112.37 | $112.37 | |
Cigna
| Facility | $182.98 | $182.98 | $182.98 | |
Providence
| Facility | $182.98 | $182.98 | $182.98 | |
Providence
| Professional | $84.09 | $109.94 | $236.00 | |
United
| Professional | $150.40 | $185.61 | $204.81 |