| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.93 | $37.93 | $87.30 | |
Cigna
| Facility | $29.21 | $29.21 | $114.09 | |
Cigna
| Professional | $29.21 | $36.69 | $36.69 | |
Providence
| Facility | $29.21 | $29.21 | $114.09 | |
Providence
| Professional | $36.69 | $39.79 | $51.92 | |
United
| Professional | $36.69 | $36.69 | $36.69 |