| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $86.39 | $96.06 | $166.68 | |
Cigna
| Facility | $87.83 | $87.83 | $177.76 | |
Cigna
| Professional | $79.26 | $79.26 | $87.83 | |
Providence
| Facility | $87.83 | $87.83 | $177.76 | |
Providence
| Professional | $79.26 | $85.99 | $112.16 | |
United
| Professional | $79.26 | $79.26 | $79.26 |