| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.81 | $105.20 | $105.20 | |
Cigna
| Facility | $96.80 | $96.80 | $96.80 | |
Cigna
| Professional | $87.28 | $87.28 | $96.80 | |
Providence
| Facility | $96.80 | $96.80 | $96.80 | |
Providence
| Professional | $87.28 | $94.69 | $123.51 | |
United
| Professional | $87.28 | $87.28 | $87.28 |