| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.04 | $108.87 | $438.54 | |
Cigna
| Facility | $159.59 | $159.59 | $159.59 | |
Cigna
| Professional | $62.01 | $159.59 | $159.59 | |
Providence
| Facility | $116.35 | $159.59 | $195.44 | |
Providence
| Professional | $119.78 | $119.78 | $178.12 | |
United
| Professional | $61.33 | $64.45 | $75.83 |