| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $91.90 | $101.80 | $175.51 | |
Cigna
| Facility | $282.88 | $282.88 | $282.88 | |
Cigna
| Professional | $147.91 | $282.88 | $282.88 | |
Providence
| Facility | $179.02 | $266.50 | $282.88 | |
Providence
| Professional | $147.91 | $282.88 | $292.08 | |
United
| Professional | $342.87 | $342.87 | $342.87 |