| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $32.96 | $47.80 | $69.23 | |
Cigna
| Facility | $77.81 | $77.81 | $77.81 | |
Cigna
| Professional | $55.30 | $77.81 | $77.81 | |
Providence
| Facility | $40.65 | $49.47 | $77.81 | |
Providence
| Professional | $45.56 | $71.48 | $84.12 | |
United
| Professional | $82.16 | $88.48 | $114.04 |