| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.59 | $71.14 | $71.14 | |
Cigna
| Facility | $25.89 | $25.89 | $25.89 | |
Cigna
| Professional | $25.89 | $25.89 | $25.89 | |
Providence
| Facility | $25.89 | $25.89 | $25.89 | |
Providence
| Professional | $19.43 | $19.43 | $25.89 | |
United
| Professional | $26.70 | $32.95 | $36.35 |