| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $246.31 | $854.28 | $854.28 | |
Cigna
| Facility | $138.76 | $233.17 | $233.17 | |
Cigna
| Professional | $138.76 | $189.62 | $233.17 | |
Providence
| Facility | $123.81 | $222.07 | $233.17 | |
Providence
| Professional | $138.76 | $175.01 | $255.38 | |
United
| Professional | $100.13 | $110.79 | $175.71 |