| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $68.20 | $74.33 | $86.70 | |
Cigna
| Facility | $73.01 | $73.01 | $149.94 | |
Cigna
| Professional | $68.20 | $68.20 | $77.01 | |
Providence
| Facility | $68.20 | $104.02 | $321.70 | |
Providence
| Professional | $68.20 | $160.99 | $625.58 | |
United
| Professional | $68.20 | $68.20 | $68.20 |