| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $59.24 | $69.29 | $93.41 | |
Cigna
| Facility | $122.51 | $122.51 | $122.51 | |
Cigna
| Professional | $69.04 | $86.26 | $122.51 | |
Providence
| Facility | $61.78 | $74.89 | $122.51 | |
Providence
| Professional | $75.05 | $132.47 | $204.16 | |
United
| Professional | $110.74 | $131.08 | $149.16 |