| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $48.70 | $168.92 | $168.92 | |
Cigna
| Facility | $37.25 | $61.47 | $61.47 | |
Cigna
| Professional | $37.25 | $49.99 | $61.47 | |
Providence
| Facility | $32.64 | $58.54 | $61.47 | |
Providence
| Professional | $37.25 | $46.13 | $61.51 | |
United
| Professional | $26.40 | $29.21 | $45.01 |