| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
Cigna
| Professional | $141.25 | $141.25 | $141.25 | |
Providence
| Facility | $39.81 | $43.65 | $74.13 | |
Providence
| Professional | $60.26 | $79.43 | $85.11 |