| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.77 | $15.45 | $15.45 | |
Aetna
| Professional | $9.77 | $10.01 | $13.87 | |
Cigna
| Facility | $9.77 | $9.77 | $9.77 | |
Cigna
| Professional | $9.77 | $9.77 | $9.77 | |
Providence
| Facility | $9.11 | $9.77 | $9.77 | |
Providence
| Professional | $9.77 | $9.77 | $9.77 | |
United
| Professional | $9.77 | $9.77 | $9.77 |