| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.43 | $53.63 | $130.04 | |
Cigna
| Facility | $33.65 | $33.65 | $33.65 | |
Cigna
| Professional | $33.65 | $74.09 | $133.03 | |
Providence
| Facility | $19.17 | $55.65 | $107.53 | |
Providence
| Professional | $33.65 | $87.27 | $209.38 | |
United
| Professional | $70.80 | $123.75 | $168.71 |