| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.53 | $972.99 | $972.99 | |
Cigna
| Facility | $211.82 | $297.62 | $297.62 | |
Cigna
| Professional | $211.82 | $297.62 | $297.62 | |
Providence
| Facility | $113.91 | $211.82 | $297.62 | |
Providence
| Professional | $162.27 | $211.82 | $297.62 | |
United
| Professional | $144.97 | $154.02 | $244.27 |