| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.84 | $21.84 | $21.84 | |
Cigna
| Facility | $32.60 | $32.60 | $32.60 | |
Cigna
| Professional | $21.05 | $21.05 | $32.60 | |
Providence
| Facility | $32.60 | $32.60 | $32.60 | |
Providence
| Professional | $21.05 | $29.45 | $38.99 | |
United
| Professional | $21.05 | $21.05 | $21.05 |