| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $70.75 | $395.57 | $395.57 | |
Cigna
| Facility | $89.20 | $104.58 | $350.66 | |
Cigna
| Professional | $89.20 | $89.20 | $89.20 | |
Providence
| Facility | $89.20 | $104.58 | $350.66 | |
Providence
| Professional | $55.37 | $55.37 | $89.20 | |
United
| Professional | $25.84 | $25.84 | $61.52 |