| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.47 | $57.20 | $65.59 | |
Cigna
| Facility | $62.45 | $62.45 | $125.27 | |
Cigna
| Professional | $52.47 | $52.47 | $62.45 | |
Providence
| Facility | $52.47 | $62.45 | $72.06 | |
Providence
| Professional | $52.47 | $60.61 | $66.83 | |
United
| Professional | $52.47 | $52.47 | $52.47 |