| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $91.20 | $128.82 | $173.78 | |
Cigna
| Facility | $281.84 | $281.84 | $302.00 | |
Cigna
| Professional | $147.91 | $281.84 | $302.00 | |
Providence
| Facility | $95.50 | $165.96 | $281.84 | |
Providence
| Professional | $79.43 | $125.89 | $346.74 | |
United
| Professional | $125.89 | $125.89 | $125.89 |