| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $40.49 | $92.29 | $92.29 | |
Cigna
| Facility | $69.84 | $69.84 | $139.41 | |
Cigna
| Professional | $69.84 | $71.95 | $136.71 | |
Providence
| Facility | $43.24 | $85.05 | $139.41 | |
Providence
| Professional | $69.84 | $126.18 | $163.80 | |
United
| Professional | $54.20 | $56.30 | $68.72 |