| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $40.28 | $48.33 | $63.06 | |
Cigna
| Facility | $83.08 | $83.08 | $83.08 | |
Cigna
| Professional | $47.02 | $58.43 | $83.08 | |
Providence
| Facility | $41.70 | $50.99 | $83.08 | |
Providence
| Professional | $51.44 | $90.79 | $136.91 | |
United
| Professional | $76.08 | $91.06 | $106.95 |