| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.95 | $447.01 | $447.01 | |
Cigna
| Facility | $100.80 | $135.56 | $205.43 | |
Cigna
| Professional | $80.12 | $100.15 | $100.80 | |
Providence
| Facility | $100.80 | $135.56 | $205.43 | |
Providence
| Professional | $62.57 | $62.57 | $100.80 | |
United
| Professional | $29.20 | $29.20 | $69.52 |