| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.98 | $167.63 | $167.63 | |
Cigna
| Facility | $37.79 | $44.32 | $148.60 | |
Cigna
| Professional | $17.86 | $37.79 | $37.79 | |
Providence
| Facility | $37.79 | $44.32 | $148.60 | |
Providence
| Professional | $23.46 | $23.46 | $37.79 | |
United
| Professional | $10.95 | $10.95 | $26.07 |