| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.84 | $5.84 | $5.84 | |
Cigna
| Facility | $5.78 | $5.78 | $12.71 | |
Cigna
| Professional | $5.78 | $6.17 | $6.17 | |
Providence
| Facility | $5.78 | $5.78 | $12.71 | |
Providence
| Professional | $3.86 | $5.78 | $6.92 | |
United
| Professional | $12.20 | $12.20 | $12.20 |