| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $148.32 | $151.47 | $785.89 | |
Cigna
| Facility | $241.87 | $241.87 | $241.87 | |
Cigna
| Professional | $241.87 | $257.24 | $293.54 | |
Providence
| Facility | $129.28 | $163.15 | $451.10 | |
Providence
| Professional | $145.90 | $241.87 | $295.91 | |
United
| Professional | $241.92 | $264.32 | $423.34 |