| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.25 | $147.91 | $173.78 | |
Cigna
| Facility | $144.54 | $144.54 | $151.36 | |
Cigna
| Professional | $144.54 | $151.36 | $151.36 | |
Providence
| Facility | $144.54 | $177.83 | $281.84 | |
Providence
| Professional | $79.43 | $125.89 | $204.17 | |
United
| Professional | $125.89 | $125.89 | $162.18 |