| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.45 | $58.59 | $112.48 | |
Cigna
| Facility | $55.81 | $55.81 | $126.16 | |
Cigna
| Professional | $49.03 | $49.03 | $55.81 | |
Providence
| Facility | $55.81 | $55.81 | $126.16 | |
Providence
| Professional | $49.03 | $53.20 | $69.39 | |
United
| Professional | $49.03 | $49.03 | $49.03 |