| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $39.28 | $77.38 | $149.26 | |
Cigna
| Professional | $16.11 | $16.11 | $20.13 | |
Providence
| Facility | $39.28 | $77.38 | $149.26 | |
Providence
| Professional | $22.65 | $32.08 | $52.53 | |
United
| Professional | $10.11 | $10.16 | $41.19 |