| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.35 | $37.35 | $37.35 | |
Cigna
| Facility | $58.89 | $321.69 | $819.74 | |
Cigna
| Professional | $38.25 | $38.25 | $58.89 | |
Providence
| Facility | $58.89 | $321.69 | $819.74 | |
Providence
| Professional | $36.22 | $51.33 | $82.86 | |
United
| Professional | $37.50 | $37.50 | $37.50 |