| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $91.11 | $667.11 | $667.11 | |
Cigna
| Facility | $144.01 | $182.08 | $182.08 | |
Cigna
| Professional | $144.00 | $148.33 | $182.08 | |
Providence
| Facility | $96.68 | $173.41 | $182.08 | |
Providence
| Professional | $136.66 | $144.01 | $189.81 | |
United
| Professional | $78.19 | $86.51 | $99.04 |