| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.78 | $19.20 | $370.96 | |
Cigna
| Facility | $19.98 | $19.98 | $19.98 | |
Cigna
| Professional | $17.62 | $17.62 | $19.98 | |
Providence
| Facility | $19.98 | $19.98 | $19.98 | |
Providence
| Professional | $17.62 | $19.11 | $24.93 | |
United
| Professional | $17.62 | $17.62 | $17.62 |