| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.53 | $564.98 | $564.98 | |
Cigna
| Facility | $181.40 | $181.40 | $181.40 | |
Cigna
| Professional | $115.70 | $181.40 | $183.33 | |
Providence
| Facility | $89.43 | $186.55 | $199.87 | |
Providence
| Professional | $108.05 | $162.09 | $233.80 | |
United
| Professional | $152.75 | $191.75 | $315.44 |