| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $76.55 | $82.61 | $87.92 | |
Cigna
| Facility | $81.61 | $81.61 | $81.61 | |
Cigna
| Professional | $75.79 | $81.61 | $81.61 | |
Providence
| Facility | $75.79 | $81.61 | $149.29 | |
Providence
| Professional | $77.56 | $82.23 | $173.95 | |
United
| Professional | $75.79 | $75.79 | $75.79 |