| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.70 | $89.14 | $89.14 | |
Cigna
| Facility | $25.14 | $33.65 | $33.65 | |
Cigna
| Professional | $25.14 | $33.65 | $33.65 | |
Providence
| Facility | $15.77 | $32.06 | $33.65 | |
Providence
| Professional | $25.14 | $25.27 | $33.70 | |
United
| Professional | $12.75 | $14.11 | $22.38 |