| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $20.00 | $128.86 | |
BCBS
| Professional | $261.32 | $261.32 | $261.32 | |
Cigna
| Professional | $262.20 | $291.33 | $291.33 | |
Providence
| Facility | $20.00 | $21.40 | $141.75 | |
Providence
| Professional | $291.33 | $291.33 | $291.33 |