| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.50 | $46.00 | $67.63 | |
Cigna
| Facility | $77.81 | $77.81 | $77.81 | |
Cigna
| Professional | $55.30 | $77.81 | $77.81 | |
Providence
| Facility | $40.65 | $50.43 | $77.81 | |
Providence
| Professional | $45.56 | $71.48 | $84.12 | |
United
| Professional | $80.08 | $90.48 | $126.28 |