| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.77 | $600.41 | $600.41 | |
Cigna
| Facility | $52.17 | $183.28 | $183.28 | |
Cigna
| Professional | $52.17 | $183.28 | $183.28 | |
Providence
| Facility | $52.17 | $87.65 | $183.28 | |
Providence
| Professional | $52.17 | $99.91 | $183.28 | |
United
| Professional | $94.18 | $95.03 | $156.97 |