| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.99 | $26.99 | $26.99 | |
Cigna
| Facility | $33.65 | $33.65 | $73.91 | |
Cigna
| Professional | $27.64 | $27.64 | $33.65 | |
Providence
| Facility | $33.65 | $33.65 | $73.91 | |
Providence
| Professional | $22.43 | $30.83 | $40.24 | |
United
| Professional | $27.10 | $27.10 | $27.10 |