| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.51 | $172.11 | $172.11 | |
Cigna
| Facility | $29.64 | $50.80 | $50.80 | |
Cigna
| Professional | $29.64 | $50.80 | $50.80 | |
Providence
| Facility | $24.94 | $48.38 | $50.80 | |
Providence
| Professional | $38.11 | $38.96 | $55.64 | |
United
| Professional | $20.17 | $22.32 | $37.20 |