| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.35 | $41.35 | $41.35 | |
Aetna
| Professional | $36.13 | $36.13 | $41.35 | |
Cigna
| Facility | $40.71 | $40.71 | $40.71 | |
Cigna
| Professional | $40.71 | $40.71 | $40.71 | |
Providence
| Facility | $32.99 | $40.71 | $40.71 | |
Providence
| Professional | $40.71 | $40.71 | $40.71 | |
United
| Professional | $39.90 | $39.90 | $39.90 |