| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $80.27 | $587.71 | $587.71 | |
Cigna
| Facility | $147.05 | $221.58 | $221.58 | |
Cigna
| Professional | $147.05 | $221.58 | $221.58 | |
Providence
| Facility | $104.61 | $211.03 | $221.58 | |
Providence
| Professional | $166.30 | $169.98 | $222.96 | |
United
| Professional | $84.60 | $93.61 | $143.24 |