| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.72 | $107.78 | $107.78 | |
Cigna
| Facility | $21.38 | $40.67 | $40.67 | |
Cigna
| Professional | $21.38 | $40.67 | $40.67 | |
Providence
| Facility | $19.07 | $38.72 | $40.67 | |
Providence
| Professional | $21.38 | $30.52 | $40.69 | |
United
| Professional | $15.43 | $17.05 | $19.54 |