| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.30 | $56.60 | $56.60 | |
Cigna
| Facility | $11.23 | $21.40 | $21.40 | |
Cigna
| Professional | $11.23 | $17.41 | $21.40 | |
Providence
| Facility | $10.02 | $20.38 | $21.40 | |
Providence
| Professional | $11.23 | $16.07 | $21.42 | |
United
| Professional | $8.11 | $8.96 | $14.22 |