| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $45.00 | $45.00 | $153.63 | |
Cigna
| Professional | $45.00 | $112.78 | $153.63 | |
Providence
| Facility | $45.00 | $120.05 | $180.45 | |
Providence
| Professional | $45.00 | $112.78 | $153.63 | |
United
| Professional | $58.50 | $63.64 | $73.39 |