| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $146.94 | $158.58 | $168.76 | |
Cigna
| Facility | $155.16 | $155.16 | $155.16 | |
Cigna
| Professional | $145.49 | $155.16 | $155.16 | |
Providence
| Facility | $145.49 | $149.85 | $155.16 | |
Providence
| Professional | $147.46 | $157.84 | $205.88 | |
United
| Professional | $145.49 | $145.49 | $145.49 |