| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.57 | $71.26 | $326.32 | |
Cigna
| Facility | $70.70 | $122.92 | $122.92 | |
Cigna
| Professional | $70.70 | $122.92 | $122.92 | |
Providence
| Facility | $49.07 | $117.07 | $122.92 | |
Providence
| Professional | $70.70 | $92.26 | $123.01 | |
United
| Professional | $48.59 | $51.62 | $59.10 |