| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $145.75 | $176.28 | $1,055.01 | |
Cigna
| Facility | $272.36 | $272.36 | $272.36 | |
Cigna
| Professional | $149.69 | $149.69 | $272.36 | |
Providence
| Facility | $272.36 | $272.36 | $272.36 | |
Providence
| Professional | $170.92 | $206.89 | $272.36 | |
United
| Professional | $227.23 | $245.86 | $345.42 |