| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.69 | $532.23 | $532.23 | |
Cigna
| Facility | $100.43 | $155.88 | $155.88 | |
Cigna
| Professional | $100.43 | $126.78 | $155.88 | |
Providence
| Facility | $80.94 | $148.47 | $155.88 | |
Providence
| Professional | $100.43 | $117.01 | $156.01 | |
United
| Professional | $65.45 | $72.43 | $110.83 |