| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.56 | $97.71 | $97.71 | |
Cigna
| Facility | $88.83 | $88.83 | $88.83 | |
Cigna
| Professional | $80.91 | $80.91 | $88.83 | |
Providence
| Facility | $88.83 | $88.83 | $88.83 | |
Providence
| Professional | $80.91 | $87.78 | $114.50 | |
United
| Professional | $80.91 | $80.91 | $80.91 |