| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.49 | $103.75 | $103.75 | |
Cigna
| Facility | $37.76 | $37.76 | $37.76 | |
Cigna
| Professional | $37.76 | $37.76 | $37.76 | |
Providence
| Facility | $37.76 | $37.76 | $37.76 | |
Providence
| Professional | $28.34 | $28.34 | $37.76 | |
United
| Professional | $38.94 | $48.05 | $53.02 |