| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $41.84 | $44.34 | $100.00 | |
Cigna
| Professional | $22.57 | $22.57 | $22.57 | |
Providence
| Facility | $28.27 | $44.86 | $62.69 | |
Providence
| Professional | $22.57 | $47.07 | $10,000.00 | |
United
| Professional | $21.20 | $23.46 | $33.65 |