| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $108.04 | $116.60 | $124.08 | |
Cigna
| Facility | $43.22 | $43.22 | $43.22 | |
Cigna
| Professional | $41.08 | $43.22 | $106.97 | |
Providence
| Facility | $43.22 | $106.97 | $110.18 | |
Providence
| Professional | $43.22 | $116.05 | $121.53 | |
United
| Professional | $106.97 | $106.97 | $106.97 |