| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $78.83 | $440.78 | $440.78 | |
Cigna
| Facility | $99.40 | $116.54 | $390.74 | |
Cigna
| Professional | $99.40 | $99.40 | $99.40 | |
Providence
| Facility | $99.40 | $116.54 | $390.74 | |
Providence
| Professional | $61.70 | $61.70 | $99.40 | |
United
| Professional | $24.97 | $28.79 | $59.55 |