| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.79 | $52.79 | $52.79 | |
Cigna
| Facility | $139.08 | $139.08 | $181.77 | |
Cigna
| Professional | $139.08 | $178.25 | $178.25 | |
Providence
| Facility | $56.24 | $139.08 | $181.77 | |
Providence
| Professional | $118.82 | $178.25 | $213.57 | |
United
| Professional | $70.36 | $73.40 | $109.38 |