| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.53 | $15.32 | $15.32 | |
Cigna
| Facility | $21.56 | $21.56 | $21.56 | |
Cigna
| Professional | $21.56 | $30.15 | $30.15 | |
Providence
| Facility | $21.56 | $21.56 | $21.56 | |
Providence
| Professional | $14.37 | $21.56 | $30.15 | |
United
| Professional | $17.50 | $17.50 | $17.50 |