| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.95 | $80.88 | $421.66 | |
Cigna
| Facility | $128.30 | $128.30 | $128.30 | |
Cigna
| Professional | $81.02 | $128.30 | $237.34 | |
Providence
| Facility | $75.26 | $110.91 | $151.80 | |
Providence
| Professional | $85.87 | $132.10 | $220.13 | |
United
| Professional | $118.10 | $140.94 | $173.96 |