| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $59.63 | $67.13 | $164.56 | |
Cigna
| Facility | $64.88 | $64.88 | $181.46 | |
Cigna
| Professional | $54.71 | $54.71 | $64.88 | |
Providence
| Facility | $64.88 | $64.88 | $181.46 | |
Providence
| Professional | $54.71 | $59.35 | $77.42 | |
United
| Professional | $54.71 | $54.71 | $54.71 |