| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $92.45 | $99.78 | $106.19 | |
Cigna
| Facility | $78.26 | $78.26 | $78.26 | |
Cigna
| Professional | $74.38 | $78.26 | $91.54 | |
Providence
| Facility | $78.26 | $86.30 | $91.54 | |
Providence
| Professional | $78.26 | $99.31 | $99.31 | |
United
| Professional | $91.54 | $91.54 | $91.54 |