| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.71 | $142.19 | $770.21 | |
Cigna
| Professional | $108.92 | $108.92 | $198.23 | |
Providence
| Professional | $124.46 | $150.59 | $198.23 | |
United
| Professional | $170.54 | $179.55 | $252.26 |