| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $412.09 | $851.10 | $914.81 | |
BCBS
| Professional | $168.96 | $168.96 | $168.96 | |
Cigna
| Professional | $71.76 | $750.60 | $750.60 | |
Providence
| Facility | $89.68 | $170.35 | $896.80 | |
Providence
| Professional | $71.76 | $115.92 | $750.60 | |
United
| Professional | $60.85 | $60.85 | $363.50 |