| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.15 | $67.15 | $73.87 | |
Cigna
| Facility | $27.34 | $27.34 | $48.50 | |
Cigna
| Professional | $27.34 | $74.02 | $74.02 | |
Providence
| Facility | $27.34 | $27.34 | $48.50 | |
Providence
| Professional | $16.47 | $25.34 | $74.02 | |
United
| Professional | $74.68 | $74.68 | $79.31 |