| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.20 | $16.20 | $16.20 | |
Cigna
| Facility | $30.29 | $30.29 | $55.76 | |
Cigna
| Professional | $30.29 | $31.20 | $54.68 | |
Providence
| Facility | $17.23 | $34.07 | $55.76 | |
Providence
| Professional | $30.29 | $50.47 | $65.52 | |
United
| Professional | $21.68 | $22.52 | $33.52 |