| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.36 | $28.36 | $28.36 | |
Cigna
| Facility | $12.60 | $12.60 | $12.60 | |
Cigna
| Professional | $12.60 | $12.60 | $12.98 | |
Providence
| Facility | $12.60 | $12.60 | $12.60 | |
Providence
| Professional | $12.60 | $12.60 | $12.98 | |
United
| Professional | $13.25 | $13.25 | $22.08 |