| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.78 | $123.91 | $589.38 | |
Cigna
| Facility | $176.67 | $176.67 | $176.67 | |
Cigna
| Professional | $114.02 | $176.67 | $326.29 | |
Providence
| Facility | $104.50 | $167.87 | $249.84 | |
Providence
| Professional | $118.47 | $182.25 | $303.69 | |
United
| Professional | $165.13 | $202.20 | $260.64 |