| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $84.48 | $84.48 | $109.84 | |
Cigna
| Facility | $157.74 | $157.74 | $274.85 | |
Cigna
| Professional | $92.77 | $92.77 | $157.74 | |
Providence
| Facility | $157.74 | $157.74 | $274.85 | |
Providence
| Professional | $92.77 | $123.50 | $186.75 | |
United
| Professional | $93.60 | $93.60 | $99.40 |