| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.62 | $84.00 | $84.85 | |
Cigna
| Professional | $42.55 | $42.55 | $42.55 | |
Providence
| Facility | $61.62 | $84.59 | $118.19 | |
Providence
| Professional | $42.55 | $90.08 | $10,000.00 | |
United
| Professional | $40.88 | $44.22 | $44.22 |