| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.43 | $567.13 | $567.13 | |
Cigna
| Facility | $127.89 | $149.94 | $502.74 | |
Cigna
| Professional | $127.89 | $127.89 | $127.89 | |
Providence
| Facility | $127.89 | $149.94 | $502.74 | |
Providence
| Professional | $79.38 | $79.38 | $127.89 | |
United
| Professional | $37.04 | $37.04 | $88.20 |