| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.90 | $200.75 | $200.75 | |
Cigna
| Facility | $45.27 | $53.07 | $177.95 | |
Cigna
| Professional | $13.78 | $45.27 | $45.27 | |
Providence
| Facility | $45.27 | $53.07 | $177.95 | |
Providence
| Professional | $28.10 | $28.10 | $45.27 | |
United
| Professional | $11.47 | $13.11 | $31.22 |