| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $180.20 | $198.21 | $198.21 | |
Cigna
| Facility | $168.78 | $168.78 | $451.52 | |
Cigna
| Professional | $168.78 | $203.81 | $203.81 | |
Providence
| Facility | $168.78 | $168.78 | $451.52 | |
Providence
| Professional | $101.29 | $168.78 | $203.81 | |
United
| Professional | $205.63 | $205.63 | $218.36 |