| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $96.42 | $96.42 | $140.10 | |
Cigna
| Professional | $96.42 | $140.10 | $140.10 | |
Providence
| Facility | $81.17 | $106.74 | $160.43 | |
Providence
| Professional | $96.42 | $106.80 | $140.10 | |
United
| Professional | $60.16 | $66.56 | $110.95 |