| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.37 | $14.37 | $14.37 | |
Cigna
| Facility | $14.21 | $14.21 | $14.21 | |
Cigna
| Professional | $14.21 | $14.21 | $14.21 | |
Providence
| Facility | $14.21 | $14.21 | $14.21 | |
Providence
| Professional | $14.21 | $14.21 | $14.21 | |
United
| Professional | $9.46 | $9.69 | $16.17 |