| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $168.45 | $168.45 | $174.86 |
Aetna
| Professional | 26 | $90.00 | $153.16 | $600.96 |
Cigna
| Professional | 26 | $116.23 | $153.86 | $203.67 |
Providence
| Professional | 26 | $116.23 | $170.35 | $203.67 |
United
| Professional | 26 | $90.98 | $95.15 | $211.83 |