| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $68.92 | $504.68 | $504.68 | |
Cigna
| Facility | $89.11 | $147.51 | $147.51 | |
Cigna
| Professional | $89.11 | $119.95 | $147.51 | |
Providence
| Facility | $78.31 | $140.49 | $147.51 | |
Providence
| Professional | $89.11 | $110.71 | $147.61 | |
United
| Professional | $63.34 | $70.09 | $80.23 |