| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.43 | $83.18 | $100.00 | |
Cigna
| Facility | $85.11 | $85.11 | $85.11 | |
Cigna
| Professional | $85.11 | $85.11 | $85.11 | |
Providence
| Facility | $83.18 | $100.00 | $199.53 | |
Providence
| Professional | $79.43 | $85.11 | $173.78 | |
United
| Professional | $125.89 | $125.89 | $162.18 |