| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.11 | $49.79 | $49.79 | |
Cigna
| Facility | $18.11 | $18.11 | $18.11 | |
Cigna
| Professional | $18.11 | $18.11 | $18.11 | |
Providence
| Facility | $18.11 | $18.11 | $18.11 | |
Providence
| Professional | $13.60 | $13.60 | $18.11 | |
United
| Professional | $18.69 | $23.06 | $25.45 |