| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $180.76 | $195.97 | $293.27 | |
Cigna
| Facility | $186.49 | $186.49 | $333.71 | |
Cigna
| Professional | $165.83 | $165.83 | $186.49 | |
Providence
| Facility | $186.49 | $186.49 | $333.71 | |
Providence
| Professional | $165.83 | $179.91 | $234.66 | |
United
| Professional | $165.83 | $165.83 | $165.83 |