| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $110.60 | $128.53 | $743.69 | |
Cigna
| Facility | 26 | $42.59 | $42.59 | $52.65 |
Cigna
| Professional | $102.87 | $154.59 | $275.18 | |
Providence
| Facility | 26 | $42.59 | $42.59 | $52.65 |
Providence
| Professional | $129.36 | $201.91 | $326.82 | |
United
| Professional | $98.08 | $130.28 | $228.80 |