| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $163.24 | $176.17 | $187.48 | |
Cigna
| Facility | $161.62 | $192.83 | $192.83 | |
Cigna
| Professional | $161.62 | $192.83 | $192.83 | |
Providence
| Facility | $161.62 | $192.83 | $344.93 | |
Providence
| Professional | $175.35 | $175.35 | $345.00 | |
United
| Professional | $161.62 | $161.62 | $161.62 |