| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.71 | $142.19 | $770.21 | |
Cigna
| Professional | $109.51 | $109.51 | $199.28 | |
Providence
| Professional | $125.12 | $151.38 | $199.28 | |
United
| Professional | $152.56 | $182.15 | $252.26 |