| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Cigna
| Facility | $32.74 | $32.74 | $32.74 | |
Cigna
| Professional | $32.74 | $32.74 | $33.72 | |
Providence
| Facility | $25.00 | $32.74 | $32.74 | |
Providence
| Professional | $32.74 | $32.74 | $33.72 |