| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $70.28 | $70.28 | $70.28 | |
Cigna
| Facility | $47.32 | $47.32 | $103.94 | |
Cigna
| Professional | $47.32 | $60.25 | $60.25 | |
Providence
| Facility | $47.32 | $47.32 | $103.94 | |
Providence
| Professional | $31.55 | $47.32 | $60.25 | |
United
| Professional | $70.56 | $70.56 | $70.56 |