| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.77 | $45.77 | $79.98 | |
Cigna
| Facility | $15.77 | $15.77 | $62.09 | |
Cigna
| Professional | $15.77 | $46.87 | $46.87 | |
Providence
| Facility | $15.77 | $15.77 | $62.09 | |
Providence
| Professional | $29.12 | $46.34 | $71.05 | |
United
| Professional | $45.95 | $45.95 | $45.95 |