| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.26 | $302.13 | $302.13 | |
Cigna
| Facility | $59.89 | $113.86 | $113.86 | |
Cigna
| Professional | $59.89 | $113.86 | $113.86 | |
Providence
| Facility | $53.42 | $108.44 | $113.86 | |
Providence
| Professional | $59.89 | $85.46 | $113.95 | |
United
| Professional | $43.21 | $47.81 | $54.73 |