| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.87 | $370.67 | $370.67 | |
Cigna
| Facility | $60.21 | $110.24 | $110.24 | |
Cigna
| Professional | $60.21 | $89.64 | $110.24 | |
Providence
| Facility | $53.72 | $104.99 | $110.24 | |
Providence
| Professional | $60.21 | $82.74 | $112.91 | |
United
| Professional | $43.45 | $48.07 | $76.23 |