| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | 26 | $44.68 | $265.00 | $291.50 |
Cigna
| Facility | 26 | $44.69 | $44.69 | $55.25 |
Cigna
| Professional | 26 | $33.78 | $35.65 | $85.05 |
Providence
| Facility | 26 | $44.69 | $44.69 | $55.25 |
Providence
| Professional | 26 | $34.01 | $44.69 | $60.44 |
United
| Professional | 26 | $26.78 | $27.58 | $55.78 |