| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.39 | $11.32 | $12.99 | |
Cigna
| Facility | $12.75 | $12.75 | $30.71 | |
Cigna
| Professional | $10.39 | $10.39 | $12.75 | |
Providence
| Facility | $4.88 | $12.57 | $17.66 | |
Providence
| Professional | $10.56 | $13.00 | $13.23 | |
United
| Professional | $10.39 | $10.39 | $10.39 |