| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.10 | $271.70 | $271.70 | |
Cigna
| Facility | $58.84 | $98.87 | $98.87 | |
Cigna
| Professional | $58.84 | $80.40 | $98.87 | |
Providence
| Facility | $52.50 | $94.16 | $98.87 | |
Providence
| Professional | $58.84 | $74.20 | $99.84 | |
United
| Professional | $42.46 | $46.98 | $71.89 |