| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $108.96 | $120.78 | $256.33 | |
Cigna
| Facility | $113.05 | $113.05 | $290.22 | |
Cigna
| Professional | $99.97 | $99.97 | $113.05 | |
Providence
| Facility | $113.05 | $113.05 | $290.22 | |
Providence
| Professional | $99.97 | $108.46 | $141.47 | |
United
| Professional | $99.97 | $99.97 | $99.97 |