| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.98 | $17.78 | $371.54 | |
Cigna
| Facility | $19.95 | $19.95 | $19.95 | |
Cigna
| Professional | $17.78 | $17.78 | $19.95 | |
Providence
| Facility | $19.95 | $19.95 | $19.95 | |
Providence
| Professional | $18.20 | $25.12 | $85.11 | |
United
| Professional | $17.78 | $17.78 | $17.78 |