| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.84 | $523.79 | $798.89 | |
Cigna
| Professional | $143.93 | $165.87 | $249.68 | |
Providence
| Professional | $106.55 | $164.05 | $249.68 | |
United
| Professional | $216.91 | $250.16 | $421.81 |