| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $46.80 | $46.80 | $89.15 | |
Cigna
| Professional | $46.80 | $63.80 | $89.15 | |
Providence
| Facility | $46.80 | $67.92 | $102.08 | |
Providence
| Professional | $46.80 | $63.80 | $89.15 | |
United
| Professional | $35.21 | $38.49 | $44.39 |