| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $139.07 | $1,018.31 | $1,018.31 | |
Cigna
| Facility | $165.40 | $370.58 | $370.58 | |
Cigna
| Professional | $165.40 | $301.36 | $370.58 | |
Providence
| Facility | $147.58 | $352.93 | $370.58 | |
Providence
| Professional | $165.40 | $278.14 | $370.85 | |
United
| Professional | $119.36 | $132.05 | $209.44 |