| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.10 | $64.48 | $103.45 | |
Cigna
| Facility | $73.36 | $106.74 | $138.57 | |
Cigna
| Professional | $106.16 | $106.74 | $172.84 | |
Providence
| Facility | $70.34 | $98.44 | $138.57 | |
Providence
| Professional | $55.00 | $82.50 | $117.13 |