| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.79 | $67.36 | $305.77 | |
Cigna
| Facility | $97.68 | $97.68 | $97.68 | |
Cigna
| Professional | $61.80 | $61.80 | $97.68 | |
Providence
| Facility | $97.68 | $97.68 | $97.68 | |
Providence
| Professional | $61.80 | $67.05 | $204.96 | |
United
| Professional | $61.80 | $61.80 | $61.80 |