| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $140.55 | $785.88 | $785.88 | |
Cigna
| Facility | $177.22 | $207.77 | $696.65 | |
Cigna
| Professional | $71.28 | $177.22 | $177.22 | |
Providence
| Facility | $177.22 | $207.77 | $696.65 | |
Providence
| Professional | $110.00 | $110.00 | $177.22 | |
United
| Professional | $51.33 | $51.33 | $122.22 |