| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.98 | $190.26 | $190.26 | |
Cigna
| Facility | $30.91 | $51.93 | $51.93 | |
Cigna
| Professional | $30.91 | $42.23 | $51.93 | |
Providence
| Facility | $27.58 | $49.46 | $51.93 | |
Providence
| Professional | $30.91 | $38.97 | $51.97 | |
United
| Professional | $22.30 | $24.67 | $37.76 |