| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.36 | $258.97 | $258.97 | |
Cigna
| Facility | $57.03 | $97.57 | $97.57 | |
Cigna
| Professional | $57.03 | $97.57 | $97.57 | |
Providence
| Facility | $45.79 | $92.92 | $97.57 | |
Providence
| Professional | $57.03 | $73.22 | $97.63 | |
United
| Professional | $37.04 | $40.98 | $68.30 |