| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.67 | $23.67 | $23.67 | |
Cigna
| Facility | $49.68 | $49.68 | $81.50 | |
Cigna
| Professional | $49.68 | $51.17 | $79.92 | |
Providence
| Facility | $25.22 | $49.68 | $81.50 | |
Providence
| Professional | $49.68 | $73.77 | $95.76 | |
United
| Professional | $31.64 | $32.92 | $49.06 |