| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $88.86 | $95.89 | $102.05 | |
Cigna
| Facility | $108.36 | $108.36 | $108.36 | |
Cigna
| Professional | $87.98 | $108.36 | $108.36 | |
Providence
| Facility | $87.98 | $108.36 | $118.94 | |
Providence
| Professional | $95.45 | $95.45 | $163.63 | |
United
| Professional | $87.98 | $87.98 | $87.98 |