| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.03 | $318.86 | $318.86 | |
Cigna
| Facility | $71.91 | $84.30 | $282.66 | |
Cigna
| Professional | $71.91 | $71.91 | $71.91 | |
Providence
| Facility | $71.91 | $84.30 | $282.66 | |
Providence
| Professional | $44.63 | $44.63 | $71.91 | |
United
| Professional | $20.83 | $20.83 | $49.59 |