| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.90 | $320.70 | $907.75 | |
Cigna
| Facility | $79.92 | $79.92 | $79.92 | |
Cigna
| Professional | $79.92 | $112.76 | $222.41 | |
Providence
| Facility | $40.02 | $79.92 | $137.36 | |
Providence
| Professional | $79.92 | $142.30 | $318.85 | |
United
| Professional | $232.56 | $287.39 | $398.66 |