| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $115.39 | $116.76 | $116.76 | |
Cigna
| Professional | $119.58 | $119.58 | $119.58 | |
Providence
| Professional | $119.58 | $119.58 | $133.02 | |
United
| Professional | $117.24 | $117.24 | $117.24 |