| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $301.97 | $301.97 | $301.97 | |
Cigna
| Professional | $40.57 | $40.57 | $598.20 | |
Providence
| Facility | $33.90 | $51.40 | $190.67 | |
Providence
| Professional | $40.57 | $40.57 | $598.20 | |
United
| Professional | $23.00 | $25.54 | $235.32 |