| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $127.92 | $153.62 | $216.24 | |
BCBS
| Professional | $106.74 | $106.74 | $210.32 | |
Cigna
| Facility | 26 | $106.74 | $106.74 | $131.94 |
Cigna
| Professional | $124.49 | $210.32 | $304.58 | |
Providence
| Facility | 26 | $106.74 | $106.74 | $131.94 |
Providence
| Professional | $129.08 | $215.14 | $333.52 | |
United
| Professional | $128.47 | $147.12 | $225.63 |