| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $94.16 | $526.49 | $526.49 | |
Cigna
| Facility | $118.73 | $159.66 | $241.96 | |
Cigna
| Professional | $47.63 | $117.71 | $118.73 | |
Providence
| Facility | $118.73 | $159.66 | $241.96 | |
Providence
| Professional | $73.69 | $73.69 | $118.73 | |
United
| Professional | $34.39 | $34.39 | $95.13 |