| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $89.54 | $105.63 | $140.22 | |
Cigna
| Facility | $184.03 | $184.03 | $184.03 | |
Cigna
| Professional | $104.45 | $129.97 | $184.03 | |
Providence
| Facility | $92.75 | $113.29 | $184.03 | |
Providence
| Professional | $112.90 | $202.83 | $304.57 | |
United
| Professional | $165.60 | $200.68 | $228.35 |