| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $46.22 | $46.22 | $49.83 | |
Cigna
| Facility | $12.62 | $12.62 | $27.72 | |
Cigna
| Professional | $12.62 | $47.34 | $47.34 | |
Providence
| Facility | $12.62 | $12.62 | $27.72 | |
Providence
| Professional | $8.41 | $12.94 | $57.92 | |
United
| Professional | $46.41 | $46.41 | $46.41 |