| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.27 | $275.45 | $275.45 | |
Cigna
| Facility | $62.12 | $72.83 | $244.19 | |
Cigna
| Professional | $29.43 | $62.12 | $62.12 | |
Providence
| Facility | $62.12 | $72.83 | $244.19 | |
Providence
| Professional | $38.56 | $38.56 | $62.12 | |
United
| Professional | $17.98 | $17.98 | $42.84 |