| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $46.23 | $338.50 | $338.50 | |
Cigna
| Facility | $65.90 | $92.39 | $92.39 | |
Cigna
| Professional | $65.90 | $75.13 | $92.39 | |
Providence
| Facility | $49.06 | $87.99 | $92.39 | |
Providence
| Professional | $65.90 | $69.34 | $92.46 | |
United
| Professional | $39.68 | $43.90 | $67.18 |