| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.53 | $57.77 | $61.48 | |
Cigna
| Facility | $113.14 | $113.14 | $113.14 | |
Cigna
| Professional | $53.00 | $113.14 | $113.14 | |
Providence
| Facility | $53.00 | $96.21 | $113.14 | |
Providence
| Professional | $57.50 | $57.50 | $113.14 | |
United
| Professional | $53.00 | $53.00 | $53.00 |