| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.81 | $50.81 | $50.81 | |
Aetna
| Professional | $44.39 | $44.39 | $50.81 | |
Cigna
| Facility | $45.46 | $45.46 | $45.46 | |
Cigna
| Professional | $45.46 | $45.46 | $45.46 | |
Providence
| Facility | $44.57 | $45.46 | $45.46 | |
Providence
| Professional | $45.46 | $45.46 | $45.46 |