| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.86 | $13.86 | $13.86 | |
Aetna
| Professional | $13.86 | $24.87 | $26.45 | |
Cigna
| Professional | $39.46 | $39.46 | $39.46 | |
Providence
| Facility | $23.28 | $33.63 | $37.81 | |
Providence
| Professional | $39.46 | $39.46 | $39.46 | |
United
| Professional | $25.80 | $30.60 | $42.21 |