| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.28 | $57.50 | $135.85 | |
Cigna
| Facility | $59.12 | $59.12 | $121.88 | |
Cigna
| Professional | $52.75 | $59.12 | $59.12 | |
Providence
| Facility | $52.75 | $59.12 | $84.55 | |
Providence
| Professional | $56.19 | $57.24 | $61.09 | |
United
| Professional | $52.75 | $52.75 | $52.75 |