| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $92.43 | $516.78 | $516.78 | |
Cigna
| Facility | $116.54 | $156.72 | $237.49 | |
Cigna
| Professional | $54.10 | $115.12 | $116.54 | |
Providence
| Facility | $116.54 | $136.63 | $237.49 | |
Providence
| Professional | $72.33 | $80.37 | $116.54 | |
United
| Professional | $33.76 | $33.76 | $110.46 |