| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $90.90 | $91.83 | $106.09 | |
Cigna
| Professional | $43.62 | $43.62 | $43.62 | |
Providence
| Facility | $53.33 | $68.58 | $93.90 | |
Providence
| Professional | $43.62 | $97.49 | $10,000.00 | |
United
| Professional | $40.97 | $45.34 | $65.04 |