| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.52 | $28.80 | $34.51 | |
Cigna
| Professional | $28.52 | $28.52 | $38.38 | |
Providence
| Facility | $28.52 | $29.37 | $39.99 | |
Providence
| Professional | $28.52 | $38.39 | $40.35 | |
United
| Professional | $28.52 | $28.52 | $28.52 |