| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.24 | $66.12 | $87.64 | |
Aetna
| Professional | 26 | $40.31 | $44.89 | $62.35 |
Cigna
| Facility | 26 | $69.41 | $69.41 | $82.50 |
Cigna
| Professional | $50.63 | $86.26 | $280.55 | |
Cigna
| Professional | 26 | $35.60 | $59.00 | $191.35 |
Providence
| Facility | 26 | $69.41 | $69.41 | $82.50 |
Providence
| Professional | $61.19 | $97.73 | $152.94 | |
Providence
| Professional | 26 | $35.60 | $58.89 | $69.41 |
United
| Professional | $84.60 | $104.40 | $122.40 | |
United
| Professional | 26 | $60.16 | $74.25 | $122.10 |