| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.63 | $90.10 | $123.58 | |
Aetna
| Professional | 25 | $73.05 | $92.38 | $118.22 |
BCBS
| Professional | $77.81 | $77.81 | $140.38 | |
Cigna
| Professional | $50.00 | $80.00 | $139.68 | |
Providence
| Facility | $39.49 | $58.19 | $102.38 | |
Providence
| Professional | $51.87 | $84.76 | $140.38 | |
United
| Professional | $101.20 | $139.43 | $166.82 |