| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $98.92 | $106.75 | $367.61 | |
Cigna
| Facility | $114.35 | $114.35 | $114.35 | |
Cigna
| Professional | $97.94 | $114.35 | $114.35 | |
Providence
| Facility | $97.94 | $114.35 | $206.25 | |
Providence
| Professional | $106.26 | $106.26 | $198.00 | |
United
| Professional | $97.94 | $97.94 | $97.94 |