| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.49 | $158.49 | $158.49 | |
Cigna
| Professional | $25.12 | $25.12 | $25.12 | |
Providence
| Facility | $15.85 | $158.49 | $281.84 | |
Providence
| Professional | $60.26 | $79.43 | $85.11 |