| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $123.13 | $447.00 | $651.33 | |
Cigna
| Facility | $152.47 | $152.47 | $152.47 | |
Cigna
| Professional | $152.47 | $165.87 | $203.70 | |
Providence
| Facility | $93.64 | $234.00 | $239.72 | |
Providence
| Professional | $99.89 | $153.66 | $211.58 | |
United
| Professional | $183.60 | $213.00 | $342.24 |