| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $123.79 | $610.90 | $610.90 | |
Cigna
| Professional | $139.91 | $184.03 | $184.03 | |
Providence
| Professional | $109.34 | $154.91 | $236.60 | |
United
| Professional | $172.13 | $195.30 | $318.19 |