| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.58 | $34.58 | $34.58 | |
Cigna
| Facility | $4.73 | $4.73 | $10.40 | |
Cigna
| Professional | $4.73 | $35.40 | $35.40 | |
Providence
| Facility | $4.73 | $4.73 | $10.40 | |
Providence
| Professional | $3.15 | $4.84 | $41.66 | |
United
| Professional | $34.72 | $34.72 | $34.72 |