| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $124.65 | $124.65 | $124.65 | |
Cigna
| Facility | $96.22 | $96.22 | $211.32 | |
Cigna
| Professional | $63.43 | $63.43 | $96.22 | |
Providence
| Facility | $96.22 | $96.22 | $211.32 | |
Providence
| Professional | $63.43 | $63.43 | $96.22 | |
United
| Professional | $125.15 | $125.15 | $125.15 |