| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13.24 | $13.24 | $13.24 | |
Cigna
| Facility | $28.58 | $28.58 | $45.58 | |
Cigna
| Professional | $28.58 | $29.44 | $44.69 | |
Providence
| Facility | $14.10 | $28.58 | $45.58 | |
Providence
| Professional | $28.58 | $41.25 | $53.55 | |
United
| Professional | $17.70 | $18.41 | $27.42 |