| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.28 | $1,159.01 | $1,159.01 | |
Cigna
| Facility | $218.57 | $319.82 | $319.82 | |
Cigna
| Professional | $218.57 | $260.08 | $319.82 | |
Providence
| Facility | $167.97 | $304.58 | $319.82 | |
Providence
| Professional | $218.57 | $240.04 | $350.28 | |
United
| Professional | $135.85 | $150.31 | $230.01 |