| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.77 | $150.49 | $150.49 | |
Cigna
| Facility | $34.45 | $48.42 | $54.77 | |
Cigna
| Professional | $34.45 | $39.20 | $54.77 | |
Providence
| Facility | $25.38 | $52.16 | $54.77 | |
Providence
| Professional | $34.45 | $41.11 | $54.82 | |
United
| Professional | $19.98 | $22.12 | $26.02 |