| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.75 | $30.75 | $58.40 | |
Cigna
| Facility | $47.32 | $47.32 | $47.32 | |
Cigna
| Professional | $47.32 | $47.32 | $47.32 | |
Providence
| Facility | $47.32 | $47.32 | $47.32 | |
Providence
| Professional | $26.20 | $39.31 | $65.84 | |
United
| Professional | $27.44 | $27.44 | $29.14 |