| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.95 | $24.95 | $24.95 | |
Cigna
| Facility | $35.75 | $35.75 | $62.35 | |
Cigna
| Professional | $27.68 | $27.68 | $35.75 | |
Providence
| Facility | $35.75 | $35.75 | $62.35 | |
Providence
| Professional | $21.73 | $28.50 | $42.76 | |
United
| Professional | $33.17 | $33.17 | $35.22 |