| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.42 | $123.34 | $309.98 | |
Cigna
| Facility | $139.86 | $139.86 | $139.86 | |
Cigna
| Professional | $73.14 | $73.14 | $139.86 | |
Providence
| Facility | $139.86 | $139.86 | $139.86 | |
Providence
| Professional | $73.14 | $127.13 | $139.86 | |
United
| Professional | $79.53 | $118.91 | $177.46 |