| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $80.84 | $87.24 | $92.85 | |
Cigna
| Facility | $91.37 | $91.37 | $91.37 | |
Cigna
| Professional | $80.04 | $91.37 | $91.37 | |
Providence
| Facility | $80.04 | $91.37 | $780.43 | |
Providence
| Professional | $86.84 | $86.84 | $749.21 | |
United
| Professional | $80.04 | $80.04 | $80.04 |