| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.87 | $533.54 | $533.54 | |
Cigna
| Facility | $86.66 | $194.18 | $194.18 | |
Cigna
| Professional | $86.66 | $157.91 | $194.18 | |
Providence
| Facility | $77.33 | $184.93 | $194.18 | |
Providence
| Professional | $86.66 | $145.74 | $194.32 | |
United
| Professional | $62.54 | $69.19 | $105.88 |