| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.05 | $48.05 | $174.86 |
Aetna
| Professional | 26 | $38.44 | $174.86 | $265.00 |
Cigna
| Professional | 26 | $33.95 | $41.33 | $56.13 |
Providence
| Professional | 26 | $33.95 | $45.76 | $56.13 |
United
| Professional | 26 | $25.45 | $27.00 | $61.93 |