| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.85 | $214.55 | $214.55 | |
Cigna
| Facility | $43.76 | $80.91 | $80.91 | |
Cigna
| Professional | $43.76 | $80.91 | $80.91 | |
Providence
| Facility | $37.95 | $77.06 | $80.91 | |
Providence
| Professional | $59.90 | $62.07 | $80.95 | |
United
| Professional | $30.70 | $33.96 | $52.33 |