| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.16 | $374.62 | $374.62 | |
Cigna
| Facility | $83.99 | $102.25 | $102.25 | |
Cigna
| Professional | $83.99 | $89.54 | $102.25 | |
Providence
| Facility | $54.29 | $97.38 | $102.25 | |
Providence
| Professional | $76.73 | $83.99 | $109.42 | |
United
| Professional | $43.91 | $48.58 | $61.60 |