| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.22 | $102.47 | $391.83 | |
Cigna
| Facility | $75.19 | $75.19 | $75.19 | |
Cigna
| Professional | $52.91 | $75.19 | $112.00 | |
Providence
| Facility | $36.96 | $54.55 | $75.01 | |
Providence
| Professional | $63.91 | $90.55 | $145.06 | |
United
| Professional | $107.61 | $126.67 | $157.74 |