| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.22 | $147.03 | $431.50 | |
Cigna
| Facility | $155.79 | $155.79 | $155.79 | |
Cigna
| Professional | $134.88 | $155.79 | $155.79 | |
Providence
| Facility | $134.88 | $155.79 | $174.99 | |
Providence
| Professional | $146.34 | $146.34 | $174.99 | |
United
| Professional | $134.88 | $134.88 | $134.88 |