| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.13 | $156.79 | $320.70 | |
Cigna
| Facility | $147.83 | $147.83 | $147.83 | |
Cigna
| Professional | $129.47 | $129.47 | $147.83 | |
Providence
| Facility | $147.83 | $147.83 | $147.83 | |
Providence
| Professional | $129.47 | $140.47 | $183.23 | |
United
| Professional | $129.47 | $129.47 | $129.47 |