| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.13 | $42.13 | $42.13 | |
Cigna
| Facility | $61.09 | $61.09 | $61.09 | |
Cigna
| Professional | $21.94 | $60.50 | $61.09 | |
Providence
| Facility | $61.09 | $61.09 | $61.09 | |
Providence
| Professional | $39.47 | $50.56 | $65.78 | |
United
| Professional | $17.66 | $17.73 | $42.22 |