| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $90.52 | $662.84 | $662.84 | |
Cigna
| Facility | $124.31 | $269.04 | $269.04 | |
Cigna
| Professional | $124.31 | $269.04 | $269.04 | |
Providence
| Facility | $107.14 | $256.23 | $269.04 | |
Providence
| Professional | $189.09 | $201.93 | $269.24 | |
United
| Professional | $86.65 | $95.87 | $146.71 |