| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $256.08 | $279.13 | $320.11 | |
Cigna
| Facility | $305.41 | $305.41 | $585.30 | |
Cigna
| Professional | $256.08 | $256.08 | $305.41 | |
Providence
| Facility | $256.08 | $303.13 | $338.04 | |
Providence
| Professional | $256.08 | $299.08 | $326.14 | |
United
| Professional | $256.08 | $256.08 | $256.08 |