| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.55 | $21.02 | $21.02 | |
Cigna
| Facility | $22.69 | $22.69 | $22.69 | |
Cigna
| Professional | $18.50 | $18.50 | $22.69 | |
Providence
| Facility | $22.69 | $22.69 | $22.69 | |
Providence
| Professional | $18.50 | $23.56 | $26.18 | |
United
| Professional | $18.50 | $18.50 | $18.50 |