| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $86.04 | $87.69 | $94.90 | |
Cigna
| Facility | $91.02 | $91.02 | $91.02 | |
Cigna
| Professional | $78.93 | $78.93 | $91.02 | |
Providence
| Facility | $91.02 | $91.02 | $91.02 | |
Providence
| Professional | $78.93 | $85.64 | $111.71 | |
United
| Professional | $78.93 | $78.93 | $78.93 |