| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.29 | $41.29 | $102.00 | |
Cigna
| Facility | $55.89 | $55.89 | $115.29 | |
Cigna
| Professional | $43.41 | $43.41 | $55.89 | |
Providence
| Facility | $55.89 | $55.89 | $115.29 | |
Providence
| Professional | $43.41 | $47.09 | $61.43 | |
United
| Professional | $43.41 | $43.41 | $43.41 |