| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.44 | $66.97 | $76.80 | |
Cigna
| Facility | $77.16 | $77.16 | $227.57 | |
Cigna
| Professional | $61.44 | $61.44 | $79.81 | |
Providence
| Facility | $61.44 | $77.16 | $130.91 | |
Providence
| Professional | $68.25 | $78.25 | $82.50 | |
United
| Professional | $61.44 | $61.44 | $61.44 |