| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $131.09 | $959.87 | $959.87 | |
Cigna
| Facility | $227.96 | $361.77 | $361.77 | |
Cigna
| Professional | $227.96 | $294.18 | $361.77 | |
Providence
| Facility | $169.75 | $344.54 | $361.77 | |
Providence
| Professional | $227.96 | $271.51 | $362.02 | |
United
| Professional | $137.29 | $151.90 | $173.88 |