| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $152.30 | $170.91 | $381.00 | |
Cigna
| Facility | 26 | $34.70 | $34.70 | $42.90 |
Cigna
| Professional | $115.50 | $358.60 | $360.02 | |
Providence
| Facility | 26 | $34.70 | $34.70 | $42.90 |
Providence
| Professional | $223.43 | $329.06 | $502.60 | |
United
| Professional | $151.91 | $221.95 | $389.78 |