| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.05 | $10.05 | $10.05 | |
Aetna
| Professional | $10.05 | $15.55 | $18.26 | |
Cigna
| Professional | $28.39 | $28.39 | $28.39 | |
Providence
| Facility | $16.73 | $23.70 | $26.88 | |
Providence
| Professional | $28.39 | $28.39 | $28.39 | |
United
| Professional | $18.13 | $21.93 | $30.24 |