| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.41 | $376.93 | $376.93 | |
Cigna
| Facility | $85.00 | $99.65 | $334.13 | |
Cigna
| Professional | $29.43 | $85.00 | $85.00 | |
Providence
| Facility | $85.00 | $99.65 | $334.13 | |
Providence
| Professional | $52.76 | $52.76 | $85.00 | |
United
| Professional | $24.51 | $24.62 | $58.62 |