| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.83 | $599.20 | $599.20 | |
Cigna
| Facility | $119.29 | $200.45 | $200.45 | |
Cigna
| Professional | $119.29 | $200.45 | $200.45 | |
Providence
| Facility | $106.43 | $190.90 | $200.45 | |
Providence
| Professional | $150.44 | $153.78 | $219.54 | |
United
| Professional | $86.08 | $95.24 | $109.02 |