| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $96.75 | $100.38 | $100.38 | |
Cigna
| Facility | $102.80 | $102.80 | $102.80 | |
Cigna
| Professional | $102.80 | $102.80 | $102.80 | |
Providence
| Facility | $96.75 | $120.94 | $151.18 | |
Providence
| Professional | $102.80 | $145.13 | $151.18 | |
United
| Professional | $100.78 | $100.78 | $100.78 |