| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $127.01 | $127.01 | $174.86 |
Aetna
| Professional | 26 | $90.00 | $265.00 | $291.50 |
Cigna
| Professional | 26 | $101.21 | $123.22 | $167.34 |
Providence
| Professional | 26 | $101.21 | $136.41 | $167.34 |
United
| Professional | 26 | $75.77 | $83.84 | $184.37 |