| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.27 | $77.98 | $83.00 | |
Cigna
| Facility | $81.68 | $81.68 | $81.68 | |
Cigna
| Professional | $71.55 | $81.68 | $81.68 | |
Providence
| Facility | $71.55 | $73.70 | $83.15 | |
Providence
| Professional | $71.55 | $77.63 | $83.15 | |
United
| Professional | $71.55 | $71.55 | $71.55 |