| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $146.96 | $668.57 | $668.57 | |
Cigna
| Facility | $202.96 | $202.96 | $202.96 | |
Cigna
| Professional | $189.31 | $202.96 | $202.96 | |
Providence
| Facility | $202.96 | $258.70 | $263.75 | |
Providence
| Professional | $124.87 | $180.50 | $270.20 | |
United
| Professional | $198.64 | $229.20 | $356.14 |