| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.05 | $142.37 | $142.37 | |
Cigna
| Facility | $40.14 | $53.67 | $53.67 | |
Cigna
| Professional | $40.14 | $53.67 | $53.67 | |
Providence
| Facility | $25.18 | $51.11 | $53.67 | |
Providence
| Professional | $40.14 | $40.28 | $53.71 | |
United
| Professional | $20.37 | $22.54 | $35.74 |