| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $62.21 | $79.70 | $87.68 | |
Cigna
| Facility | $59.79 | $59.79 | $59.79 | |
Cigna
| Professional | $59.79 | $78.92 | $78.92 | |
Providence
| Facility | $59.79 | $59.79 | $59.79 | |
Providence
| Professional | $66.00 | $85.62 | $111.68 | |
United
| Professional | $78.92 | $78.92 | $78.92 |