| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.43 | $111.33 | $236.25 | |
Cigna
| Facility | $171.94 | $171.94 | $171.94 | |
Cigna
| Professional | $171.94 | $171.94 | $344.40 | |
Providence
| Facility | $84.80 | $150.79 | $188.49 | |
Providence
| Professional | $113.21 | $226.10 | $355.33 | |
United
| Professional | $360.88 | $416.67 | $608.66 |