| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.15 | $38.90 | $46.77 | |
Cigna
| Facility | $39.81 | $39.81 | $39.81 | |
Cigna
| Professional | $39.81 | $39.81 | $39.81 | |
Providence
| Facility | $38.02 | $46.77 | $199.53 | |
Providence
| Professional | $7.59 | $79.43 | $125.89 | |
United
| Professional | $38.90 | $125.89 | $125.89 |