| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $78.89 | $441.10 | $441.10 | |
Cigna
| Facility | $99.47 | $116.62 | $391.02 | |
Cigna
| Professional | $47.12 | $99.47 | $99.47 | |
Providence
| Facility | $99.47 | $116.62 | $391.02 | |
Providence
| Professional | $61.74 | $61.74 | $99.47 | |
United
| Professional | $41.16 | $41.16 | $75.45 |