| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.31 | $107.60 | $108.70 | |
Cigna
| Professional | $58.28 | $58.28 | $58.28 | |
Providence
| Facility | $68.95 | $88.66 | $121.41 | |
Providence
| Professional | $58.28 | $115.40 | $10,000.00 | |
United
| Professional | $54.74 | $60.57 | $91.24 |