| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $113.57 | $124.93 | $701.55 | |
Cigna
| Facility | $146.91 | $146.91 | $440.97 | |
Cigna
| Professional | $112.45 | $112.45 | $146.91 | |
Providence
| Facility | $146.91 | $146.91 | $440.97 | |
Providence
| Professional | $112.45 | $122.00 | $159.13 | |
United
| Professional | $112.45 | $112.45 | $112.45 |