| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $366.15 | $366.15 | $366.15 | |
Cigna
| Facility | $11.04 | $11.04 | $24.25 | |
Cigna
| Professional | $11.04 | $374.98 | $374.98 | |
Providence
| Facility | $11.04 | $11.04 | $24.25 | |
Providence
| Professional | $7.36 | $11.32 | $374.98 | |
United
| Professional | $367.63 | $367.63 | $367.63 |