| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $146.84 | $195.62 | $1,062.78 | |
Cigna
| Professional | $150.88 | $150.88 | $274.99 | |
Providence
| Professional | $172.58 | $208.90 | $274.99 | |
United
| Professional | $206.49 | $251.98 | $347.95 |