| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.87 | $24.12 | $75.17 | |
Cigna
| Facility | $33.97 | $33.97 | $87.91 | |
Cigna
| Professional | $23.88 | $23.88 | $33.97 | |
Providence
| Facility | $23.88 | $41.70 | $199.92 | |
Providence
| Professional | $29.88 | $51.74 | $76.03 | |
United
| Professional | $23.88 | $23.88 | $23.88 |