| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.44 | $36.44 | $36.44 | |
Cigna
| Facility | $47.13 | $47.13 | $125.47 | |
Cigna
| Professional | $47.13 | $48.54 | $123.04 | |
Providence
| Facility | $38.85 | $76.45 | $125.47 | |
Providence
| Professional | $47.13 | $113.56 | $147.41 | |
United
| Professional | $48.67 | $50.67 | $75.56 |