| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.32 | $8.33 | $8.33 | |
Aetna
| Professional | $5.32 | $6.76 | $11.63 | |
Cigna
| Facility | $5.32 | $5.32 | $5.32 | |
Cigna
| Professional | $5.32 | $5.32 | $5.32 | |
Providence
| Facility | $5.05 | $5.32 | $5.32 | |
Providence
| Professional | $5.32 | $5.32 | $5.32 | |
United
| Professional | $5.32 | $5.32 | $5.32 |