| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.75 | $87.50 | $185.38 | |
Cigna
| Facility | 26 | $38.90 | $38.90 | $48.10 |
Cigna
| Professional | $62.47 | $97.27 | $129.61 | |
Providence
| Facility | 26 | $38.90 | $38.90 | $48.10 |
Providence
| Professional | $64.14 | $102.27 | $164.43 | |
United
| Professional | $60.23 | $60.27 | $105.84 |