| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $2.00 | |
Providence
| Facility | $1.78 | $1.78 | $3.89 | |
Providence
| Professional | $79.43 | $79.43 | $85.11 | |
United
| Facility | $0.42 | $0.42 | $2.09 | |
United
| Professional | $4.17 | $4.17 | $4.17 |