| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.00 | $10.00 | $10.00 | |
Aetna
| Professional | $12.02 | $15.49 | $18.20 | |
Cigna
| Professional | $28.18 | $28.18 | $28.18 | |
Providence
| Facility | $16.60 | $23.44 | $26.92 | |
Providence
| Professional | $12.02 | $21.38 | $28.18 | |
United
| Professional | $18.20 | $21.88 | $32.36 |