| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.09 | $240.85 | $240.85 | |
Cigna
| Facility | $87.66 | $87.66 | $87.66 | |
Cigna
| Professional | $87.66 | $87.66 | $87.66 | |
Providence
| Facility | $87.66 | $87.66 | $87.66 | |
Providence
| Professional | $65.79 | $65.79 | $87.66 | |
United
| Professional | $90.39 | $107.70 | $123.09 |