| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $70.70 | $71.40 | $77.77 | |
Cigna
| Facility | $83.94 | $83.94 | $83.94 | |
Cigna
| Professional | $70.70 | $83.94 | $83.94 | |
Providence
| Facility | $70.70 | $83.94 | $119.28 | |
Providence
| Professional | $76.69 | $76.69 | $119.28 | |
United
| Professional | $70.70 | $70.70 | $70.70 |