| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $40.40 | $40.40 | $40.40 | |
Cigna
| Professional | $30.30 | $40.40 | $40.40 | |
Providence
| Facility | $24.44 | $38.47 | $53.70 | |
Providence
| Professional | $30.30 | $40.40 | $40.40 | |
United
| Professional | $17.41 | $18.94 | $21.85 |