| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $45.70 | $47.42 | $47.42 | |
Cigna
| Facility | $168.06 | $168.06 | $168.06 | |
Cigna
| Professional | $48.56 | $168.06 | $168.06 | |
Providence
| Facility | $48.56 | $147.22 | $184.03 | |
Providence
| Professional | $48.56 | $168.06 | $184.03 | |
United
| Professional | $57.13 | $57.13 | $57.13 |